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Using Photodynamic Therapy to Estimate Effectiveness of Innovative Combined Diclofenac and Tazaroten Therapy of Disseminated Actinic Keratosis
Beata J. Osiecka
; Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
Kamil Jurczyszyn
; Department of Oral Surgery, Wroclaw Medical University, 50-425 Wroclaw, Poland
Piotr Nockowski
; Department and Clinic of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
Artur Lipniski
; Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
Agnieszka Sieja
; Department of Maxillofacial Orthodontics and Orthopedics, Wroclaw Medical University, 50-425 Wrocław, Poland
Piotr Ziółkowski
; Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland
Abstract
Early diagnosis and therapy of precancerous lesions and malignant tumors belong to the most challenging tasks in modern medicine. Photodynamic diagnosis can help diagnose both precancerous lesions and early carcinoma. Actinic keratosis (AK) is the most common precancerous lesion of the skin. The available data show a high effectiveness of diclofenac in treating multifocal AK. We report a case of a 52-year-old woman who complained of multiple disseminated AK lesions predominantly on the lower limbs and trunk with a significant exacerbation within the last 6 months. Due to the spreading of disease and a high number of AK foci, as well as technical problems with visiting the hospital (PDT Laboratory), photodynamic therapy was not applied. The patient was treated for 2 months with a combination of local administration of 3% diclofenac and 0.1% tazaroten and 3% diclofenac only as a half side (left-right) comparison. The effects of therapy were later clinically evaluated and verified by means of photodynamic diagnosis (PDD) directly after therapy and at a follow-up examination 3 months later. The evaluation of treatment was blinded.Treatment with diclofenac only on the right side of the body resulted in clearing of 55% of all treated lesions, which increased to 60% three months after finishing therapy. On the left side of the body, where combined therapy (diclofenac 2 times daily on uneven dates and diclofenac once a day + tazaroten once a day on even dates) was used, 77.5% pathologic lesions disappeared, but this did not increase at follow up. The treatment of multifocal, disseminated AK is a difficult task and also burdensome for the patient due to side effects like scarring or burning and itching which occur during most therapies. Combined therapy with diclofenac and tazaroten supported by PDD may improve the effects of routine treatment of AK.
Keywords
actinic keratosis; diclofenac; tazaroten; photodynamic diagnosis
Hrčak ID:
138771
URI
Publication date:
8.5.2015.
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