Photodynamic Therapy for the Treatment of Skin Cancer in Patients with Idiopathic Thrombocytopenia: A Case Report

Authors

  • Kate C. Blanco University of São Paulo, São Carlos Institute of Physics, São Carlos, São Paulo, Brazil
  • Natalia M. Inada University of São Paulo, São Carlos Institute of Physics, São Carlos, São Paulo, Brazil
  • Ana P. Silva University of São Paulo, São Carlos Institute of Physics, São Carlos, São Paulo, Brazil
  • Margarete I. Furusho Fundação Pró Hansen, Curitiba, Brazil
  • Vanderlei S. Bagnato University of São Paulo, São Carlos Institute of Physics, São Carlos, São Paulo, Brazil

DOI:

https://doi.org/10.17140/DRMTOJ-1-108

Keywords:

Idiopathic thrombocytopenia (IT), Nodular basal cell carcinoma (nBCC), Photodynamic therapy (PDT), Adjuvant therapy, Surgical risks

Abstract

Idiopathic Thrombocytopenia (IT) is an autoimmune disease in which the patients present a
reduction of blood platelets, increasing the risk of bleeding and its complications. Especially,
elderly patients those with neoplasia associated to idiopathic thrombocytopenia are more likely
to severe risks of bleeding. Here were report a case of an eighty-year-old man with diagnosis
of idiopathic thrombocytopenia and confirmed biopsy of nodular basal cell carcinoma (nBCC)
located on the nose. The use of the standard treatment surgery was not carried in this case due
to risks generated by autoimmune disease. Photodynamic Therapy (PDT) was indicated as an
adjuvant therapy associated to shaving and electrocoagulation providing elimination of recent
cancer cells. This PDT is an alternative for the treatment of modular basal cell carcinoma no
greater than 2 cm of diameter and small depth. The patient was treated with shaving, electrocoagulation
and topical PDT using 20% methyl aminolevulinate (MAL) and fluency of 150 J/cm2
with 630 nm light. This adjuvant treatment of nodular BCC is minimally invasive and can be
indicated to patients with surgical risks, and that is the importance for this report. The success
of this case is an important precedent for thousands of patients’ with similar conditions.

References

Madan V, Lear JT, Szeimies R-M. Non-melanoma skin can-cer. Lancet. 2010; 375(9715): 673-685. doi: 10.1016/S0140- 6736(09)61196-X

De Zwaan SE, Haass NK. Genetics of basal cell carci-noma. Australas J Dermatol. 2010; 51(2): 81-92; 93-94. doi: 10.1111/j.1440-0960.2009.00579.x

Ermertcan AT, Hellings PW, Cingi C. Nonmelanoma skin can-cer of the head and neck: nonsurgical treatment. Facial Plast Surg Clin North Am. 2012; 20(4): 445-454. doi: 10.1016/j. Dermatol Open J fsc.2012.08.004

Telfer NR, Colver GB, Morton CA. Guidelines for the man-agement of basal cell carcinoma. Br J Dermatol. 2008; 159(1): 35-48. doi: 10.1111/j.1365-2133.2008.08666.x

Studer P, Inderbitzin D. Surgery-related risk factors. Curr Opin Crit Care. 2009; 15(4): 328-332. doi: 10.1097/ MCC.0b013e32832be4de

Slichter SJ. Relationship between platelet count and bleed-ing risk in thrombocytopenic patients. Transfus Med Rev. 2004; 18(3): 153-167. doi: 10.1016/j.tmrv.2004.03.003

Cooper C, Fairris G, Cotton DW, Steart P, Barth JH. Dermato-myositis associated with idiopathic thrombocytopenia. Derma-tologica. 1986; 172(3): 173-176. doi: 10.1159/000249325

Ramirez DP, Kurachi C, Inada NM, et al. Experience and BCC subtypes as determinants of MAL-PDT response: Preliminary results of a national Brazilian project. Photodiagnosis Photodyn Ther. 2014; 11(1): 22-26. doi: 10.1016/j.pdpdt.2013.11.001

Dubas LE, Ingraffea A. Nonmelanoma skin cancer. Facial Plast Surg Clin North Am. 2013; 21(1): 43-53. doi: 10.1016/j. fsc.2012.10.003

Papamatheakis DG, Demers P, Vachon A, Jaimes LB, Lapointe Y, Harasymowycz PJ. Thrombocytopenia and the risks of intraocular surgery. Ophthalmic Surg Lasers Imaging. 2005; 36(2): 103-107. doi: 10.3928/1542-8877-20050301-04

Cosgarea R, Susan M, Crisan M, Senila S. Photodynamic therapy using topical 5-aminolaevulinic acid vs. surgery for basal cell carcinoma. J Eur Acad Dermatology Venereol. 2013; 27(8): 980-984. doi: 10.1111/j.1468-3083.2012.04619.x

Peng Q, Soler AM, Warloe T, Nesland JM, Giercksky KE. Selective distribution of porphyrins in skin thick cell carci-noma after topical application of methyl 5-aminolevulinate. J Photochem Photobiol Biol. 2001; 62(3): 140-145. doi: 10.1016/ S1011-1344(01)00173-7

Jori G, Fabris C, Soncin M, et al. Photodynamic therapy in the treatment of microbial infections: basic principles and per-spective applications. Lasers Surg Med. 2006; 38(5): 468-481. doi: 10.1002/lsm.20361

Braham P, Herron C, Street C, Darveau R. Antimicrobial photodynamic therapy may promote periodontal healing through multiple mechanisms. J Periodontol. 2009; 80(11): 1790-1798. doi: 10.1902/jop.2009.090214

Lubart R, Eichler M, Lavi R, Friedman H, Shainberg A. Low-energy laser irradiation promotes cellular redox activity. Photo-med Laser Surg. 2005; 23(1): 3-9. doi: 10.1089/pho.2005.23.3

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Published

2016-04-25

How to Cite

Kate C. Blanco, Natalia M. Inada, Ana P. Silva, Margarete I. Furusho, & Vanderlei S. Bagnato. (2016). Photodynamic Therapy for the Treatment of Skin Cancer in Patients with Idiopathic Thrombocytopenia: A Case Report. Dermatology, 1(1), 27–29. https://doi.org/10.17140/DRMTOJ-1-108

Issue

Vol. 1 No. 1 (2016): Volume 1 Issue 1 2016

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Articles

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