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Image Number #753 (Photodynamic Therapy)

Diagnosis: Photodynamic Therapy

Description: Application of Metvix ointment

Morphology: Red,scaly

Site: Forehead

Sex: F

Age: 57

Type: Clinical

Submitted By: Ian McColl

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Differential Diagnosis
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History:

Photodynamic therapy has recently been licensed in Australia for the treatment of superficial basal cell skin cancers and solar keratoses using Metvix ointment and an activating light source, usually a red light.  Metvix does not penetrate deeply into the skin.  It only penetrates a couple of millimetres.  This means that only superficial skin cancers are suitable for treatment with photodynamic therapy.  Red light is one of the longer wavelengths of light and therefore it will penetrate deeply enough to activate any Metvix that has penetrated into the skin and into a superficial skin cancer.  The physical characteristics of both the penetration and the light dictate the thickness of lesions that can be treated.  It is important to note that infiltrating, sclerotic or morphoeic basal cell skin cancers, micronodular basal cell skin cancers or basi-squamous cell skin cancers are not suitable for photodynamic therapy. 

Examples of BCCs not suitable for PDT therapy can be seen by clicking here.

Note that two treatments are necessary to achieve 85% success rates in treating superficial basal cell skin cancers with PDT.  The reference sources outlined below will give more information on the procedure.  The Dermnet New Zealand resource is recommended.

 

Examples of BCCs I consider suitable for PDT can be seen by clicking here.


 

DermNetNZ   eMedicine   PubMed   Dermatology Online   Archives   JAAD for "Photodynamic Therapy"

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