This book is the most up-to-date publication on fluorescence diagnostic (FDAP) and photodynamic therapy (PDT) methods used in dermatology. Both techniques are presently world wide introduced as standards for the delineation and the treatment of cutaneous precancerous stages and tumors, which show steadily increasing numbers due to e.g. more frequent sun exposure. Summarizing experiences on more than 5.000 treated patients, it offers a comprehensive information on every aspect of skin tumor detection and treatment. The main part of the book focuses on the clinical aspects giving detailed descriptions on skin tumor detection as well as photodynamic treatment of selected diseases (solar keratoses, basal cell carcinomas, squamous cell carcinomas, Bowen's disease, psoriasis lesions, etc.). The clinically oriented chapters are supplemented by practical guidelines for PDT and FDAP. The included atlas is comprised of 270 high quality color figures allowing daily use as a handbook.

Inhalt

Introduction and Historical Landmarks . Definition of the Photodynamic Action . Optimum Photosensitizing Agent for Photodynamic Action . Definition of Fluorescence Detection with ALA- Induced Porphyrins (FDAP) . Mechanisms of Action in PDT d-Aminolevulinic Acid (ALA) . Chemistry of ALA and ALA Methylester (ALA) . Metabolism of ALA . Pharmacodynamics of ALA Light Used in FDAP and PDT Unresolved Issues ind FDAP and PDT Fluorescence Detection of ALA-induced Porphyrins (FDAP) . FDAP: Evaluation of the ALA-Induced Fluoresence in Skin Diseases Ex vivo - Investigations on ALA-induced Porphyrins . Porphyrin Accumulation in Cells (in vitro) . Porphyrin Accumulation in Skin Tumors, Colon and Bronchial Carcinomas after Administration of ALA (ex vivo) In vivo - Investigations on ALA-Induced Porphyrin/FDAP . FDAP: Kinetics of ALA-induced Porphyrins in Human Cutaneous Tumors, Psoriasis Lesions and Normal Skin . FDAP: Kinetics of PorphyrinAccumulation in Solar Keratoses: ALA versus ALA Methylester . FDAP: use of the in vivo - Fluorescence for Surgical Planning . FDAP: Evaluation of the Optimum Photosensitizing Substance or its Prodrug . FDAP: Evaluation of the Optimum Exciting Light Source . FDAP: Correlation of in vivo - Tumor Fluorescence and Histopathology . FDAP: Course of FDAP in Relation to the Number of PDT-Sessions The Clinical Use of FDAP . FDAP in Clinically Well-defined Tumors . FDAP in Clinically Ill-defined Lesions . FDAP in Pretreated or Damaged Skin . Limitations of FDAP . Usefulness of FDAP in Guiding Tumor Therapies Photodynamic Therapy in Cutaneous Diseases . PDT: Evaluation of the Efficacy in Solar Keratoses . PDT: Evaluation of the Efficacy in Bowen`s Disease . PDT: Evaluation of the Efficacy in Basal Cell Carcinoma . PDT: Evaluation of the Efficacy Sqamous Cell Carcinoma . PDT: Evaluation of the Efficacy in Psoriatric Lesions . PDT: Evaluation ofthe Efficacy in Selected Cutaneous Diseases . PDT in Skin Cancers and Precanceroses Others than Discussed Above . PDT in Tumors of the Oral Mucosa . PDT in Non-neoplastic Skin Diseases . PDT in Non-dermatological Indications . PDT: Evaluation of the Optimum Photosensitizing Substance or its Prodrug . PDT: Evaluation of the Optimum Exciting Light Source General Discussion . FDAP: Indications and Limits . PDT: Indications and Limits . Safety and Tolerability of ALA-PDT . Regulatory Affairs Concerning Aminolevulinic Acid . Regulatory Affairs Concerning Aminolevulinic Acid Methylester Conclusion Summary