PHOTODYNAMIC THERAPY OF TYPICAL AND ATYPICAL KERATOACANTHOMA

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  • Authors: Molochkova Y.V.1,2, Kuntsevich Z.S.1,2, Sukhova T.E.1,2, Dibirova S.D.1,3,4, Galkin V.N.5,6, Ivanov S.A.5,6, Romanko Y.S.7,8,6
  • Affiliations:
    1. Moscow Regional Research and Clinical Institute (MONIKI)
    2. 61/2 Shchepkina ul., Moscow, 129110, Russian Federation
    3. 61/2 Shchepkina ul., Moscow, 129110, Russian Federation I.M. Sechenov First Moscow State Medical University
    4. 8/2 Trubetskaya ul., Moscow, 119991, Russian Federation
    5. A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation
    6. 10 Zhukova ul., Obninsk, Kaluzhskaya oblast', 249036, Russian Federation
    7. I.M. Sechenov First Moscow State Medical University
    8. 8/2 Trubetskaya ul., Moscow, 119991, Russian Federation A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation
  • Issue: Vol 44, No 1 (2016)
  • Pages: 64-70
  • Section: DERMATO-ONCOLOGY
  • URL: https://almclinmed.ru/jour/article/view/309
  • DOI: https://doi.org/10.18786/2072-0505-2016-44-1-64-70

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Abstract

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. 

About the authors

Yu. V. Molochkova

Moscow Regional Research and Clinical Institute
(MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Author for correspondence.
Email: yulia-molochkova@yandex.ru
MD, PhD, Senior Research Fellow, Dermatovenereology and Dermato-oncology Department Russian Federation

Zh. S. Kuntsevich

Moscow Regional Research and Clinical Institute
(MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: yulia-molochkova@yandex.ru

MD, PhD, Associate Profes- sor, Chair of Dermatovenereology and Dermato- oncology, Postgraduate Training Faculty

Russian Federation

T. E. Sukhova

Moscow Regional Research and Clinical Institute
(MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation

Email: yulia-molochkova@yandex.ru
MD, PhD, Senior Research Fellow, Dermatovenereology and Dermato-oncology Department Russian Federation

S. D. Dibirova

Moscow Regional Research and Clinical Institute
(MONIKI); 61/2 Shchepkina ul., Moscow, 129110, Russian Federation
I.M. Sechenov First Moscow State Medical University; 8/2 Trubetskaya ul., Moscow, 119991, Russian Federation

Email: yulia-molochkova@yandex.ru
MD, PhD student, Chair of Skin and Venereal Diseases, Institute for Professional Education Russian Federation

V. N. Galkin

A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation; 10 Zhukova ul., Obninsk, Kaluzhskaya oblast', 249036, Russian Federation

Email: yulia-molochkova@yandex.ru

MD, PhD, Professor, Director

Russian Federation

S. A. Ivanov

A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation; 10 Zhukova ul., Obninsk, Kaluzhskaya oblast', 249036, Russian Federation

Email: yulia-molochkova@yandex.ru
MD, PhD, Deputy Director on Science and Medicine Russian Federation

Yu. S. Romanko

I.M. Sechenov First Moscow State Medical University; 8/2 Trubetskaya ul., Moscow, 119991, Russian Federation
A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation; 10 Zhukova ul., Obninsk, Kaluzhskaya oblast', 249036, Russian Federation

Email: yulia-molochkova@yandex.ru
MD, PhD, Professor, Chair of On- cology and Radiotherapy, Institute for Professional Education, Head of Administration and Planning Division Russian Federation

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Copyright (c) 2016 Molochkova Y.V., Kuntsevich Z.S., Sukhova T.E., Dibirova S.D., Galkin V.N., Ivanov S.A., Romanko Y.S.

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