In addition to established indications in non-
melanoma skin cancer in immunocompetent patients,
photodynamic therapy (
PDT) has been studied for the treatment, and possible prevention, of superficial
skin cancers in immunosuppressed patients. As a topical
photosensitizer can be applied over large areas,
PDT is also increasingly used for field cancerization in photodamaged skin, with evidence of potential to delay the development of
actinic keratoses and
basal cell carcinoma, although direct evidence of prevention of invasive
squamous cell carcinoma remains limited.
PDT has been studied in patch/plaque-stage
cutaneous T-cell lymphoma, with efficacy more likely in unilesional disease. Accumulating evidence supports the use of
PDT in
acne and several other inflammatory/infective
dermatoses including
cutaneous leishmaniasis, although protocols are still to be refined. Despite proven efficacy,
PDT is not widely used in viral/
genital warts, where
pain during treatment can be intense.
PDT is a therapeutic option for photorejuvenation, with improvement in fine wrinkles, mottled
hyperpigmentation, roughness and sallowness reported.