研究目的
To investigate the use of ablative fractional laser-assisted photodynamic therapy (AFXL-assisted PDT) as an alternative treatment for Bowen disease in the first web space of the hand, aiming to avoid surgical complications like hypertrophic scarring or contracture.
研究成果
AFXL-assisted PDT was effective in treating Bowen disease in the first web space of the hand, with no clinical or pathological abnormalities observed after multiple sessions. This suggests PDT can be a viable alternative to surgery to avoid complications like scarring and contracture, though more sessions may be required for Asian patients or acral lesions.
研究不足
The study is based on a single case, limiting generalizability. The patient was lost to follow-up for 11 months, which may have affected treatment outcomes. Asian skin's higher pigment content may require more PDT sessions, and acral locations might have lower clearance rates. The number of treatments needed was higher than in some previous studies, possibly due to these factors.
1：Experimental Design and Method Selection:
A case report design was used to evaluate AFXL-assisted PDT for treating Bowen disease. The method involved pretreatment with a fractional CO2 laser to enhance photosensitizer absorption, followed by application of methyl aminolevulinate cream and irradiation with a 630-nm light-emitting diode.
2：Sample Selection and Data Sources:
A single 78-year-old male patient with a 2.0-cm erythematous round scaly plaque in the first web space of the right hand, diagnosed via skin biopsy as Bowen disease.
3：0-cm erythematous round scaly plaque in the first web space of the right hand, diagnosed via skin biopsy as Bowen disease.
List of Experimental Equipment and Materials:
3. List of Experimental Equipment and Materials: Fractional CO2 laser (eCO2; Lutronic Inc.), methyl aminolevulinate cream (Metvix; Galderma), 630-nm light-emitting diode (AktiliteCL128; Galderma), occlusive dressing.
4：Experimental Procedures and Operational Workflow:
The lesion was pretreated with a fractional CO2 laser (parameters: pulse energy 50 mJ, density 100 spots/cm2, power 30 W). Topical methyl aminolevulinate cream was applied and covered with an occlusive dressing for 90 minutes. The area was then irradiated with 630-nm light at a dose of 37 J/cm2. This was repeated over multiple sessions (initially 4 sessions, then 9 more sessions at 2-4 week intervals).
5：Data Analysis Methods:
Clinical and pathological evaluations were conducted through visual inspection and skin biopsies to assess treatment efficacy and absence of abnormalities.
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