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Neue Entwicklungen in der photodynamischen Therapie

New developments in photodynamic therapy

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Zusammenfassung

In diesem Übersichtsbeitrag werden neue Entwicklungen der photodynamischen Therapie (PDT) der letzten Jahre vorgestellt. Seit 2009 wurden zur Behandlung aktinischer Keratosen mit einem Aminolävulinsäure-haltigen Pflaster und einer Aminolävulinsäure-haltigen Nanoemulsion 2 neue Photosensibilisatoren zugelassen. Hinsichtlich penetrationsverbessernder Maßnahmen konnte gezeigt werden, dass durch Vorbehandlung mit einem ablativen fraktionierten Laser die Penetration des Photosensibilisators verbessert und eine intensivierte PDT akral und in feldkanzerisierter Haut ermöglicht wird. Die hautverjüngenden Effekte der PDT wurden in zahlreichen Studien nachgewiesen und die zugrunde liegenden Mechanismen aufgeklärt. Klinische Studien der letzten Jahre belegen die Wirksamkeit der PDT in der Behandlung und Prophylaxe von aktinischen Keratosen bei organtransplantierten Patienten, die ein stark erhöhtes Hautkrebsrisiko haben. Darüber hinaus wird auch die aktuelle Studienlage zur PDT mit Tageslicht (sog. Daylight-PDT) zusammengefasst.

Abstract

We review new developments in recent years in photodynamic therapy. Since 2009 two new photosensitizers, a self-adhesive 5-aminolevulinic acid (ALA) patch and a nanoemulsion formulation of 5-aminolevulinic acid have been approved for the treatment of actinic keratoses. Pretreatment with ablative fractional lasers enhances penetration of the photosensitizer and enables intensified PDT in acral lesions and in field-cancerized skin. Several clinical trials have demonstrated the skin-rejuvenating effects of photodynamic therapy, while the underlying mechanisms of action have been clarified. The efficacy of photodynamic therapy has been shown in the treatment and prophylaxis of actinic keratoses in organ transplant recipients at high risk for developing skin cancer. We also summarize the results of available studies on daylight-mediated photodynamic therapy.

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Interessenkonflikt

Die korrespondierende Autorin weist für sich und ihren Koautor auf folgende Beziehungen hin: Fr. Prof. Karrer hält für Galderma Vorträge gegen Honorar und hat an Zulassungsstudien als Prüfärztin teilgenommen.

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  1. Klinik und Poliklinik für Dermatologie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Deutschland

    E. Kohl &  S. Karrer

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  1. E. Kohl
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  2. S. Karrer
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Correspondence to S. Karrer.

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Kohl, E., Karrer, S. Neue Entwicklungen in der photodynamischen Therapie. Hautarzt 64, 363–369 (2013). https://doi.org/10.1007/s00105-012-2513-x

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