In vivo confocal microscopy efficacy assessment of daylight photodynamic therapy in actinic keratosis patients.

Seyed Jafari, Seyed Morteza; Timchik, T; Hunger, Robert (2016). In vivo confocal microscopy efficacy assessment of daylight photodynamic therapy in actinic keratosis patients. British journal of dermatology, 175(2), pp. 375-381. Wiley-Blackwell 10.1111/bjd.14517

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BACKGROUND Reflectance confocal microscopy (RCM) is a noninvasive diagnostic technique with an acceptable sensitivity and specificity for actinic keratosis (AK). OBJECTIVES We evaluated efficacy of daylight photodynamic therapy (DL-PDT) in patients with AK using a new RCM atypia scoring system. MATERIALS AND METHODS All patients with AK lesions (Grade I-II) were included in our study (2012-15). Baseline clinical, dermoscopy and RCM evaluations were followed by DL-PDT. In the first follow-up, clinical examination, dermoscopy and RCM imaging of the treated area were carried out. Atypia scoring and cell size measurements were used to compare before and after RCM images. RESULTS From 40 lesions (20 patients with mean age of 75·5 years), complete resolution and partial response of the actinic damage was detected in 80% and 17·5% of lesions, respectively. No cellular atypia was seen in the follow-up RCM images of 57·5% of lesions (n = 23), while in 40% of lesions (n = 16) minimal changes to the honeycomb pattern of the epidermis were seen in the follow-up RCM images (atypia score 1). Only one lesion showed minimal or no clinical response, and a persistent moderate amount of atypia in RCM. Furthermore, atypia score and mean cell size decreased significantly in the follow-up DL-PDT RCM images (P < 0·001, P = 0·001, respectively). CONCLUSIONS RCM features of actinic damage at cellular level have been shown to correlate well with the results of a clinical assessment of AK lesions. This study confirms that in vivo RCM technology might be an additional technique to monitor the efficacy of DL-PDT for AK.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Seyed Jafari, Seyed Morteza and Hunger, Robert

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0007-0963

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Sandra Nyffenegger

Date Deposited:

28 Feb 2017 09:43

Last Modified:

28 Feb 2017 09:43

Publisher DOI:

10.1111/bjd.14517

PubMed ID:

26949030

BORIS DOI:

10.7892/boris.93909

URI:

https://boris.unibe.ch/id/eprint/93909

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