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Journal of Zhejiang University SCIENCE B
ISSN 1673-1581(Print), 1862-1783(Online), Monthly
2025 Vol.26 No.9 P.915-922
Successful in situ 5-aminolevulinic acid photodynamic therapy in a 53-year-old female with cutaneous squamous cell carcinoma
Abstract: Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), as certain forms of non-melanoma skin cancer (NMSC) or keratinocyte carcinoma, are the most common forms of malignant neoplasms worldwide (Sharp et al., 2024). BCC and cSCC have been identified as two major components of NMSC, comprising one-third of all malignancies (Burton et al., 2016). Generally speaking, patients with NMSC tend to have relatively favorable survival outcomes, while different histopathological subtypes of NMSC exhibit distinct biological behaviors (St?tescu et al., 2023). Keratinocyte carcinoma, although not considered as deadly as melanoma, tends to metastasize if left untreated (Civantos et al., 2023; Nanz et al., 2024). cSCC can evolve locally, then aggressively metastasize, invade, and even lead to fatal consequences in a subset of patients (Winge et al., 2023). A solid, pigmented, smooth plaque or a hyperkeratotic papule with or without central ulceration and hemorrhage appears to be characteristic of cSCC (Thompson et al., 2016; Zhou et al., 2023). Of note, a rare type of intraepidermal cSCC in situ often appears as a velvety, demarcated, slightly raised erythematous plaque on the genitalia of men (Yamaguchi et al., 2016). Accounting for approximately 16.0% of scalp tumors and with a rising incidence, cSCC is now the second most common NMSC in humans (Verdaguer-Faja et al., 2024). According to the latest statistics, up to 2%–5% of cSCCs in situ may gradually progress into invasive cSCCs in the final step (Rentroia-Pacheco et al., 2023). Several risk factors for the carcinogenesis and development of cSCC have been identified, including age, accumulative exposure to ultraviolet light radiation A and B, human papillomavirus infection, arsenic ingestion, chronic scarring, xeroderma pigmentosa, a relevant history of ionizing radiation, androgenetic alopecia in males, and immunosuppression therapy (Martinez and Otley, 2001; Welsch et al., 2012; Mortaja and Demehri, 2023).
Key words: Nonmelanoma skin cancer; Cutaneous squamous cell carcinoma (cSCC); 5-Aminolevulinic acid photodynamic therapy (5-ALA PDT)
1浙江大学医学院附属第一医院皮肤科,中国杭州市,310003
2浙江大学医学院附属第一医院心内科,中国杭州市,310003
摘要:皮肤鳞状细胞癌(cSCC)是非黑色素瘤皮肤癌中最常见的肿瘤之一,根据其临床表现可分为原位、侵袭性和特殊亚型(如角化棘皮瘤、疣状癌等)。原位cSCC好发于中老年人群,常见于头面部和四肢等暴露部位,典型皮损表现为单一的、边界清晰的红色斑块。由于皮肤鳞状细胞癌的发病率和死亡率呈不断升高的趋势,亟需采取新的防治措施。5-氨基酮戊酸光动力疗法(5-ALA PDT)在临床上广泛应用于尖锐湿疣、痤疮、光线性角化病和某些皮肤恶性肿瘤(如浅表型基底细胞癌和原位cSCC等)。然而,5-ALA PDT在原位cSCC治疗中的安全性仍有待阐明。本文报道了1例53岁的原位cSCC女性患者。患者主诉"左侧鼻根皮疹一年余",皮疹局部伴有轻度疼痛,且逐渐增大。出于美容考虑,患者拒绝行扩大手术切除根治术,并要求保守治疗。因此,作为手术的替代治疗,患者每周接受1次5-ALA PDT,共治疗4周。4次治疗结束后患者皮损消退,疗效显著,未遗留明显瘢痕形成,随访2年未见肿瘤复发。
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DOI:
10.1631/jzus.B2400164
CLC number:
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On-line Access:
2025-06-23
Received:
2024-03-28
Revision Accepted:
2024-12-09
Crosschecked:
2025-09-23