Can CEYLAN, Fezal ÖZDEMİR, Alican KAZANDI

Parapsoriasis plağında topikal fotodinamik tedavi

Fotodinamik tedavi, aktinik keratoz, Bowen hastalığı, melanom dışı deri kanserleri gibi epitelyal prekanseröz ve kanseröz lezyonlarda etkili bir tedavi yöntemidir. Işığa duyarlandırıcı madde ile ışığın etkileşimi sonucu ortaya çıkan reaktif oksijen ara ürünlerinin hastalıklı dokuyu tahrip etmesi prensibine dayanır. Büyük plak tipi parapsoriasis, mikozis fungoidese dönüşebilen bir lezyondur. Bu çalışmanın amacı büyük plak tipi parapsoriasiste fotodinamik tedavinin etkinliğini saptamaktır. Çalışma kontrol grubu olmayan pilot çalışma olarak yapılmıştır. Bu amaçla 70 yaşındaki plak parapsoriasisli hasta tedavi edildi. Tedavi öncesinde histopatolojik ve klinik değerlendirme yapıldı. Daha sonra lezyon, yerel 5-aminolevülinik asit uygulamasını takiben inkoherent ışık kaynağı ile ışınlanmak suretiyle tedavi edildi. Işınlama sırasında 580-720 nm dalga boyunda kırmızı ışık bandı kullanıldı. Onsekiz aylık takip sonucu rekürrens bulgusu saptanmadı.

Anahtar Kelimeler:

Araştırma teknikleri, Fotokemoterapi, Parapsoriaz, İzleme çalışmaları, Aminolevülinik asit

Photodynamic therapy in plaque parapsoriasis

Photodynamic therapy is a treatment modality mainly effective in epithelial precancerous and cancerous lesions like actinic keratoses, Bowen's disease and nonmelanoma skin cancer. The method is based on the destruction of diseased tissue by reactive oxygen intermediates generated though the interaction of light with a photosensitizer agent. The large plaque parapsoriasis is a lesion that may progress to mycosis fungoides. The goal of this study was to determine the effectiveness of photodynamic therapy in large plaque parapsoriasis. This study was performed as a pilot study without control group. A case of 70-year-old male with plaque parapsoriasis was treated. Histopathological and clinical evaluation were performed before treatment. Then, the lesion was successfully treated by photodynamic therapy using the topical application of 5-aminolevulinic acid, followed by irradiation with incoherent visible light. The red light band was used during irradiation in the wave length of 580-720 nm. Eighteen months of follow-up revealed no recurrence finding.

Keywords:

Investigative Techniques, Photochemotherapy, Parapsoriasis, Follow-Up Studies, Aminolevulinic Acid,

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