gms | German Medical Science

Introduction: The topical photodynamic therapy (PDT) has proven its value in the treatment of basal cell cancer, actinic keratosis, and the Bowen's disease of the head-neck-area due to its high success rate and its outstanding cosmetic results. Complications and adverse effects of the PDT are going to be analyzed in the following.

Materials and methods: In a total of 146 proceedings of the PDTs in the head-neck-area, values for pain, local swelling, redness, secretion, and complications had been collected, evaluated using a visual analogue scale (value 1–10) and analyzed retrospectively.

Results: All of the patients indicated to have pain, swelling, and redness. In most instances, a secretion appeared as well. The average pain was declared 5.4, the swelling 5, the redness 6, and the secretion 4.4. In two patients, the PDT had to be carried out under general anaesthesia due to their intense pain. For pain therapy, local cooling, infiltration anesthesia, metamizol or piritramid were used. Additionally, a post-interventional therapy with cooling and natriumfusidatsalve occured. In two of the treatments, delayed phototoxical complications arose within 12 hours post treatment. In the first case, a strong swelling of the face appeared, in the second one, an extensive subdermic haemorrhage and epidermolysis appeared. Both had to be monitored in hospital and treated antibiotic and antiphlogistic. The oncologic and cosmetic result of the PDT wasn’t influenced by these complications.

Conclusion: Topical PDT turns out to be an effective option for the therapy of skin cancer in the head-neck-area. However, it is afflicted/affiliated with adverse effects and complications, whose relevance should be clarified to the patient in advance. For extensive use, in-patient treatment is advisable because of possible phototoxical complications.