Fluorescence diagnosis of non-melanoma skin cancer

2012 ◽  
Vol 153 (34) ◽  
pp. 1334-1340 ◽  
Author(s):  
Magdolna Gaál ◽  
Róbert Kui ◽  
Zsolt Hunyadi ◽  
Lajos Kemény ◽  
Rolland Gyulai
Keyword(s):  
Photodynamic Therapy ◽  
Protoporphyrin Ix ◽  
Proliferating Cells ◽  
Tumor Margins ◽  
Non Melanoma Skin Cancer ◽  
Skin Cancers ◽  
Exact Determination ◽  
Melanoma Skin

Photodynamic therapy involves – in dermatological practice usually exogenous – application of a photosensitizer then activation of accumulated protoporphyrin IX by light with an appropriate wavelength after a short incubation period. It is an evidence based method to treat certain non-melanoma skin cancers. During treatment when the excited protoporphyrin IX returns to base state, reactive oxygen species are formed leading to cell death in rapidly proliferating cells. Fluorescence of excited protoporphyrin IX can be used in diagnostics as well. In ultraviolet light, the photodamaged or neoplastic areas show coral red fluorescence which can clearly be distinguished from the much lower fluorescence of adjacent normal tissue. This process is suitable for exact determination of tumor margins so it can be used for planning surgical procedures or after photodynamic therapy at a follow up visit for the visualization of the therapeutic result. The present article reviews the literature of photodynamic diagnosi that is also used by the authors. Orv. Hetil., 2012, 153, 1334–1340.

Surgical Management of Melanoma and Other Skin Cancers

2015 ◽  
Author(s):  
Jennifer A. Wargo ◽  
Kenneth Tenabe
Keyword(s):  
Lymph Node ◽  
Surgical Treatment ◽  
Skin Cancer ◽  
Cell Carcinoma ◽  
Stage Iv ◽  
Stage Iii ◽  
Non Melanoma Skin Cancer ◽  
Skin Cancers ◽  
Stage Iv Melanoma ◽  
Melanoma Skin

The prevalence of malignant skin cancers has increased significantly over the past several years. Approximately 1.2 million cases of non-melanoma skin cancer are diagnosed per year. More alarming, up to 80,000 cases of melanoma are diagnosed per year, an incidence that has been steadily increasing, with a lifetime risk of 1 in 50 for the development of melanoma. The disturbing increase in the incidence of both non-melanoma skin cancer and melanoma can largely be attributed to the social attitude toward sun exposure. The clinical assessment and management of skin lesions can be challenging. This review describes the assessment process, including thorough history and examination; the need for possible biopsy; and excision criteria. Specific types of skin cancer are distinguished and include basal cell carcinoma; squamous cell carcinoma; and melanoma; and for each type the incidence; epidemiology; histologic subtypes; diagnosis; and both surgical and non-surgical treatments are provided. Stages I-IV of melanoma are detailed, with prognostic factors described. Surgical treatment for stages I and II include description of the margins of excision and sentinel lymph node biopsy. The surgical treatment of Stage III melanoma further includes therapeutic lymph node dissection and isolated limb perfusion. Adjuvant therapies are also presented and include radiotherapy and chemotherapy. The additional treatment of metastasectomy for Stage IV melanoma is described. For both Stage III and IV melanoma, the study of vaccines to host immune cells is reported. For Stage IV melanoma, the text also describes immunotherapy treatment. Operative procedures specific to superficial and deep groin dissections are outlined. This review contains 9 figures, 3 tables, and 96 references.

scholarly journals Techniques for fluorescence detection of protoporphyrin IX in skin cancers associated with photodynamic therapy

2013 ◽  
Vol 2 (4) ◽  
Author(s):  
Kishore R. Rollakanti ◽  
Stephen C. Kanick ◽  
Scott C. Davis ◽  
Brian W. Pogue ◽  
Edward V. Maytin
Keyword(s):  
Photodynamic Therapy ◽  
Fluorescence Detection ◽  
Aminolevulinic Acid ◽  
Protoporphyrin Ix ◽  
Skin Lesions ◽  
Wide Field ◽  
Detection Techniques ◽  
Current State ◽  
Therapeutic Outcomes ◽  
Skin Cancers

AbstractPhotodynamic therapy (PDT) is a treatment modality that uses a specific photosensitizing agent, molecular oxygen, and light of a particular wavelength to kill cells targeted by the therapy. Topically administered aminolevulinic acid (ALA) is widely used to effectively treat cancerous and precancerous skin lesions, resulting in targeted tissue damage and little to no scarring. The targeting aspect of the treatment arises from the fact that ALA is preferentially converted into protoporphyrin IX (PpIX) in neoplastic cells. To monitor the amount of PpIX in tissues, techniques have been developed to measure PpIX-specific fluorescence, which provides information useful for monitoring the abundance and location of the photosensitizer before and during the illumination phase of PDT. This review summarizes the current state of these fluorescence detection techniques. Non-invasive devices are available for point measurements, or for wide-field optical imaging, to enable monitoring of PpIX in superficial tissues. To gain access to information at greater tissue depths, multi-modal techniques are being developed which combine fluorescent measurements with ultrasound or optical coherence tomography, or with microscopic techniques such as confocal or multiphoton approaches. The tools available at present, and newer devices under development, offer the promise of better enabling clinicians to inform and guide PDT treatment planning, thereby optimizing therapeutic outcomes for patients.

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