Fluorescence Diagnosis and Photodynamic Therapy of Skin by PD. Dr. Clemens Fritsch, Univ.-Prof. Dr. Dr. h.c. Thomas

By PD. Dr. Clemens Fritsch, Univ.-Prof. Dr. Dr. h.c. Thomas Ruzicka (auth.)

This e-book is the main up to date book on fluorescence diagnostic (FDAP) and photodynamic remedy (PDT) tools utilized in dermatology. either options are almost immediately around the globe brought as criteria for the delineation and the remedy of cutaneous precancerous levels and tumors, which exhibit gradually expanding numbers as a result of e.g. extra widespread sunlight publicity. Summarizing reports on greater than 5.000 handled sufferers, it bargains a finished info on each point of pores and skin tumor detection and remedy. the most a part of the ebook specializes in the scientific points giving unique descriptions on epidermis tumor detection in addition to photodynamic remedy of chosen illnesses (solar keratoses, basal mobile carcinomas, squamous telephone carcinomas, Bowen's affliction, psoriasis lesions, etc.). The clinically orientated chapters are supplemented by means of functional directions for PDT and FDAP. The integrated atlas is made from 270 prime quality colour figures permitting day-by-day use as a handbook.

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In addition, the biochemical studies proved that the increased fluorescence intensity correlated with the concentrations extracted of porphyrin in the tumor tissues (Fritsch et aI, 1997; Grant et aI, 1993; Hua et aI, 1995, Peng et aI, 1992). However, reports on FDAP, so far, only concerned experiences with bladder cancers (Kriegmair et aI, 1994; Steinbach et aI, 1994) and intracerebral tumors (Stummer et aI, 1998). The biochemical studies on ALA-induced porphyrins presented here were the first which clearly defined the time points of maximum (optimum) porphyrin enrichment in BCC, SCC and psoriatic lesions.

Chapter Discussion Highest levels of porphyrins are achieved after 6 h in SK and normal skin. The study was focused on the application times of 1 and 6 h, because of the evaluated time course of ALA-induced porphyrin formation in epithelial skin tumors with maximum intralesional porphyrin levels between 1 and 6 h (Fritsch et aI, 1999) (Fig. 72) . Porphyrin accumulation was more intense using ALA than ALA-ME, suggesting that ALA may penetrate the epidermal barrier with subsequent conversion into porphyrins more efficiently than ALA-ME, which requires hydrolysis after penetration.

Only superficial layers of skin « 1 mm) were included in the study because of the limited penetration of topically applied ALA (Martin et ai, 1995, Peng et ai, 1995; Szeimies et aI, 1994). Immediately after excision, tissue samples were frozen in liquid nitrogen and stored at -80°C. Determination of total porphyrin and protein levels. Tissue samples were weighed and cut into small pieces. 0 N perchloric acid/methanol (111, vol/vol). In the supernatant, the total porphyrin level was assessed by fluorescence spectroscopy (Perkin Elmer LS-5, Dberlingen, Germany); emission was recorded between 520 and 700 nm at an excitation wavelength of 405 nm (Soret band).

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