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Photodynamic Therapy by Mind Map: Photodynamic Therapy
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Photodynamic Therapy

Mechanism of Action

Exogenous ALA Applicaion

Incubation (Metabolism & Accumulation)

  Definition: Time between drug application and light treatment Porphyrin precursors require an incubation period for metabolism    

Metabolism, Exogenous ALA, Heme synthesis, Iron Store depletion, Ferrochelatase, Protoporphyrin IX accumulation

Accumulation, Porphyrin levels peak in 12 hours, Optimal Incubation time for Acne treatment?, 3 hours

Light Exposure

ALA, Porphyrins (Ground Energy State), Porphyrins (Excited Energy State), Release of Photons (Energy), Reactive Oxygen Species (ROS), Cytotoxic Action, Apoptosis, Ischemic Necrosis


Irreversible oxidation of porphyrins

Starts at the onset of light exposure

Metabolism and Re-accumulation of Porphyrins

Occurs after therapeutic light exposure is completed

Instruct patients to have strict photoprotection for?, 48 hours


ALA itself is not a photosensitizer

Accumulation of Protoporphyrin IX depends on?

Cytoplasmic ALA concentration

Expression and Activity of heme-synthesis enzymes (e.g., Porphyrias)

Peripheral Benzodiazapine Receptors, PBRs are overexpressed in neoplastic cells, enhancing ALA-PDT efficacy in cancer treatment

Iron Stores

Peripheral Benzodiazapine Receptors are overexpressed in cancers

PBRs are overexpressed in  neoplastic cells, enhancing  ALA-PDT efficacy in cancer  treatment

PBRs are overexpressed in neoplastic cells, enhancing ALA-PDT efficacy in cancer treatment

Light Sources

Porphyrin Absorption Spectrum (300-650 nm)

Blue Light

Green Light, KTP, Nd:YAG

Yellow Light, PDL (e.g., LP-PDL 595 nm)

Red Light



FDA Approved

Compounds, Methyl Aminolevulinate (MAL), 5 Aminolevulinate (ALA)

Actinic Keratoses

Pregnancy Category: C

Not approved for children


Acne Vulgaris, UV light is not therapeutic, Blue Light is antiinflammatory, Red light alone is not therapeutic, Glass-filtered sunlight may be helpful (UVA), Propionibacterium acnes, Coproporphyrin III, The major porphyrin of P acnes, Absorbs UVA and Blue Light, Maximum absorption peak 415 nm (Soret Peak), Protoporphyrin IX, Mechanism of Action, Sebaceous gland destruction (ROS), P acnes reduction was NOT observed, Reduction of follicular obstruction and hyperkeratosis, Immunological changes, Longer incubation times (3 hours or more) > long-term acne remission (ALA-PDT and MAL-PDT), Red light is deeper penetrating > more likely to activate porphyrins in sebaceous glands in PDT

Basal Cell Carcinoma

Bowen's Disease

Actinic Cheilitis

Hidradenitis Suppurativa

Cosmetics, Photo-Aging


Viral Infections of the skin, HPV, Molluscum, HSV


Photosensitivity at 400-450 nm

Caution to other wavelengths


Allergies to Porphyrins

Adverse Effects

Phototoxic Reaction


HSV (Prophylaxis prior Tx)

Residual photosensitivity