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The results of a study on the effectiveness of photodynamic therapy with a photosensitizer fotoditazin and cryotherapy for actinic keratosis are represented in the article. The study included 80 patients with 215 lesions, among them erythematous form of actinic keratosis was diagnosed in 151 (70.2%) cases, hyperkeratotic form – in 46 (21.4%) cases, a pigmented form – in 12 (5.6%) and an atypical variant of the disease – in 6 (2.8%) cases. According to histological type the distribution of tumor was as follows: 19 (54.3%) cases were diagnosed as hypertrophic type, 6 (17.1%) – atrophic, 8 (22.9%) – bowenoid and 2 (5.7% ) – pigmented type. Patients from the study group received one session of photodynamic therapy using laser unit "LAMI" (662 nm) after 2 hours of application of fotoditazin 0.5% gel at dose of 0,2-0,3 ml per 1 cm2 of actinic keratosis focus with the following parameters: the energy density of the laser radiation – 200 J/cm2, power density – 0.14–0.48 W/cm2. In the control group patients underwent cryotherapy with liquid nitrogen with an exposure of 30-60 sec. The comparative analysis of the immediate results showed a tendency for the efficacy of photodynamic therapy to increase (the rate of complete regression was 92.5%) compared with cryotherapy (85.0%) (p>0,05). There were also a tendency for long-term results after photodynamic therapy to improve: three-year recurrence-free survival was 94.6% and 88.2%, respectively. For the photodynamic therapy there were significantly fewer adverse reactions, the epithelization time in lesions was significantly shorter. Compared with cryotherapy the photodynamic therapy provided significantly better cosmetic results (p

The review is on treatment of keratoacanthomas using photodynamic therapy. The defining characteristic of keratoacanthoma among epithelial tumors is a rapid spontaneous regression in the case of typical keratoacanthoma and long-term persistence, recurrence and common malignant transformation to squamous cell carcinoma in the case of atypical keratoacanthoma. In recent years, photodynamic therapy which is an effective method of treatment of different types of cancer and pre-cancer diseases of the skin including actinic keratosis, Bowen’s disease, basal cell carcinoma, is increasingly used in clinical practice. There are few data for photodynamic therapy in the treatment of keratoacanthoma. The analysis of the literature shows that using of photodynamic therapy in the set of treatment modalities in patients with keratoacanthoma improves the efficacy and reduces the terms of the therapy. In all investigations except one there was complete tumor regression in 100% patients with keratoacanthoma who underwent photodynamic therapy. In one study complete tumor regression was observed in 66.7% of patients with atypical keratoacanthoma after photodynamic therapy. The follow-up of patients in all analyzed studies accounted for at least 2-3 years. During this time none of the patients had evidence for recurrence. This approach has minimal restrictions for application. Thus, photodynamic therapy may become a therapeutic alternative to surgical treatment of keratoacanthoma with good clinical and cosmetic results.

Background: Photodynamic therapy (PDT) has shown its clinical efcacy in the treatment of keratoacanthoma. However, the published data is scarce and contradictory. Methods of a photosensitizer administration and irradiation doses depending on the type of keratoacanthoma have not been defned. Aim: To develop the diferentiated approached to PDT for typical and atypical keratoacanthoma by variation of the light density while using of a chlorine photosensitizer. Materials and methods: We assessed and treated 36 patients with cytologically and/or histologically confrmed solitary keratoacanthomas, among them 22 patients with typical and 14 patients with atypical ones. In 12 patients, persistent keratoacanthomas were diagnosed, in 1, a gigantic one and in 1, a centripetal one. Each patient was administered one session of PDT with an intralesional administration of a photosensitizer Radachlorin at a dose of 0.75 mL/cm3. The source of laser irradiation was a medical laser device LAMI (with the wave- length of 662 ± 3 nm, the power of irradiation at the edge of the light guide, 2 Wt). The absorbed light density was 50 J/cm2 for typical keratoacanthomas and 300 J/cm2 for atypical ones. 70 Results: After the treatment, in 32 (89%) of patients the tumor completely regressed within one month (26 ± 1.3 days). In 4 patients (all with atypical keratoacanthomas) the tumors did not regress within one month and was removed surgically with the 3 mm margins of obviously normal skin. At the site of former tumors, there were areas of atrophic scarring (26 cases, in 4 patients, with hyperpigmentation) or with normotrophic scarring (10 patients) that were cosmetically acceptable. Within the next 2 years of the follow-up no relapses were observed. Conclusion: Thus, we proposed an efective method of diferentiated approach to PDT of typical and atypical keratoacanthomas based on one PDT session with an intralesional administration of Radachlorin at a dose of 0.75 mg/cm3 of the tumor, with the intensity of irradiation of 0.39 Wt/cm2. The light dose density for typical keratoacanthomas is 50 J/cm2 and for atypical ones, 300 J/cm2.

Reliably established a causal role of human papillomavirus in the formation of condylomata acuminate. In 10% of people with the human papilloma virus develops condylomata acuminate, which can be transformed into malignant tumors. The most common treatment of condylomata acuminate is a conservative treatment, namely, the local chemical or physical destruction of the lesions and immunotherapy. With the ineffectiveness of conservative treatment resort to surgical excision. At the same time the traditional methods of treatment condylomata acuminate associated with high rates of recurrence. Moreover, these treatments are often associated with significant risk of bleeding, ulceration and scarring. The emergence of new methods of diagnosis and treatment of condylomata acuminate – fluorescence diagnosis and photodynamic therapy has opened up new opportunities to improve the treatment of this pathology. Topical administration of photosensitizers during photodynamic therapy is more convenient and less phototoxic and broaden the range of clinical applications of this technology in the medical dermatology. An increasing amount of evidence that photodynamic therapy with topical application of the photosensitizer is highly effective in the treatment of a variety of benign skin diseases, including condylomata acuminataca, for which traditional methods are ineffective treatment. However, many parameters of photodynamic therapy of this disease has not yet been optimized. It is necessary to conduct large-scale clinical studies on the effectiveness of photodynamic therapy of condylomata acuminatain order to standardize the treatment parameters.

The new method of photodynamic therapy for basal cell skin carcinoma with intralesional injection of photolon (at dose of 1.44-2.50 mg/cm3 of tumor volume 15 min before irradiation) was developed in the department of dermatology, venerology and dermatooncology in The State Budgetary Healthcare Institution of Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy. The efficacy of the developed method was evaluated in clinical studies in 30 patients comparing with the group of 32 patients who had conventional PDT with typical intravenous injection of photolon (at dose of 2.0–2.5 mg/kg of body weight 3 h before irradiation). The characteristics of irradiation were the same both in the study and in the control groups: power density of 0.31-0.47 W/cm2, light dose of 300 J/cm2. Compared PDT regimens had similar efficiency. As a result of the performed treatment complete tumor regression was achieved in 93.3% patients with intralesional injection of photolon and in 90.6% patients with intravenous injection. The rate of patients with 2-year recurrence-free survival after intralesional injection of photolon accounted for 96.7%; after intravenous injection – 93.8%. However, the developed method demonstrated superior safety comparing with intravenous injection of photolon: such as there was no need for light regimen after intralesional injection of photolon, there were no cases of skin phototoxicity (12.5% for intravenous injection), no increasing of transaminases (37.5% for intravenous injection).