Efficacy of photodynamic therapy in actinic cheilitis: a systematic review

A Review of the Dermatologic Clinical Applications of Topical Photodynamic Therapy

Topical photodynamic therapy is a widely approved therapy for actinic keratoses and low-risk nonmelanoma skin cancers with a rapidly growing range of emerging indications for other cutaneous diseases. This review summarizes the best-available evidence to provide a clinical update for dermatologists on the approved and emerging indications of photodynamic therapy. The body of evidence suggests that photodynamic therapy is superior or noninferior to other available treatment modalities for actinic keratoses, low-risk basal cell carcinomas, Bowen's disease, skin field cancerization, chemoprevention of keratinocyte carcinomas in organ transplant recipients, photoaging, acne vulgaris, and cutaneous infections including verrucae, onychomycosis, and cutaneous leishmaniasis. There is emerging evidence that photodynamic therapy plays a role in the management of actinic cheilitis, early-stage mycosis fungoides, extramammary Paget disease, lichen sclerosis, and folliculitis decalvans but there are no comparative studies with other active treatment modalities. Common barriers to topical photodynamic therapy include procedural pain, costs, and the time required for treatment delivery. There is significant heterogeneity in the photodynamic therapy protocols reported in the literature, including different photosensitizers, light sources, number of treatments, time between treatments, and use of procedural analgesia. Topical photodynamic therapy should be considered in the management of a spectrum of inflammatory, neoplastic, and infectious dermatoses. However, more comparative research is required to determine its role in the treatment algorithm for these dermatologic conditions and more methodological research is required to optimize photodynamic therapy protocols to improve the tolerability of the procedure for patients.

Revisiting the evidence of photodynamic therapy for oral potentially malignant disorders and oral squamous cell carcinoma: an overview of systematic reviews

BACKGROUND

This study summarized the available evidence about the use of photodynamic therapy (PDT) for the management of oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC).

METHODS

An overview of systematic reviews was undertaken based on the 2020 PRISMA statement. Electronic searches were performed in five databases. Studies published up to November 2022 were included. Risk of bias was assessed with the AMSTAR 2 tool.

RESULTS

A total of 30 studies enrolling 9,245 individuals with OPMD (n=7,487) or OSCC (n=1,758) met the selection criteria. All studies examined the efficacy and/or safety of PDT. OPMD were investigated individually in 82.8% of the studies, the most common being oral lichen planus and actinic cheilitis. OSCC was addressed separately in 10.3% of the studies, while only 6.9% evaluated both OPMD and OSCC. Fourteen different types of photosensitizers were described. PDT was used according to the following setting parameters: 417-670 nm, 10-500 mW/cm², 1.5-200 J/cm², and 0.5-143 minutes. Regarding OPMD, leukoerythroplakia showed the best response rates, while oral lichen planus presented a partial or no response in nearly 75% of documented cases. A complete response was observed in 85.9% of OSCC cases, while 14.1% had no resolution.

CONCLUSION

Overall, the response to PDT depended on the type of OPMD/OSCC and the parameters used. Although PDT is an emerging candidate for the treatment of OPMD and OSCC, there is heterogeneity of the methodologies used and the clinical data obtained, particularly regarding the follow-up period.

Antimicrobial curcumin-mediated photodynamic inactivation of bacteria in natural bovine casing

BACKGROUND

Outbreaks related to food contamination by resistant microorganisms is a worldwide concern that, motivates industries and research institutions to search for affordable solutions. Among the solutions that have been proposed, Photodynamic Inactivation (PDI) of microorganisms has gained prominence, among other aspects, because it is easy to apply and does not generate microbial resistance.

METHODS

In this study, we used the association between curcumin solubilized with Tween and light in the photodynamic inactivation process, using light-emitting diodes with a wavelength of 430 nm for decontamination S. Typhimurium and K. pneumoniae from bovine casings used as wrappers for meat products. The result was verified by counting and comparing the number of colony-forming units of the treatment concerning the negative control.

RESULTS

The solubilizer, Tween 80, used does not change the optical absorption of curcumin. An optical fluence of 150J/cm² induces a microbial log reduction of 3.8±0.2 and 2.7±0.1 for S. Typhimurium, and K. pneumoniae contaminated guts, respectively. For the 200μM concentration of curcumin, the PDI provided a microbial log reduction of 3.16±0.03 for S. Typhimurium. For K. pneumoniae, the minimal inhibitory concentration of curcumin occurs up to 12.5μM, causing an microbial log reduction of 2.08±0.03.

CONCLUSION

Both curcumin and tween are already used as additives in food production and do not pose health risks at the concentrations used. Furthermore, in the case of the material studied, the addition of curcumin favors the organoleptic quality associated with the color of the food, unlike the green or blue photossensitizers. The results pave the way for possible application of curcumin in finished meat products.