biophBiomedical PhotonicsBiomedical Photonics2413-9432Non-profit partnership for development of domestic photodynamic therapy and photodiagnosis10.24931/2413-9432-2019-8-2-25-30bioph-316Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESСовременные аспекты фотодинамической терапии актинического кератозаModern aspects of photodynamic therapy of actinic keratosesРешетовИ. В.ReshetovI. V.ФатьяноваА. С.FatyanovaA. S.БабаеваЮ. В.BabaevaYu. V.ГафаровМ. М.GafarovM. M.maratgafarov93@mail.ruОгданскаяК. В.OgdanskayaK. V.СуховаТ. Е.SuhovaT. E.КореневС. В.KorenevS. V.ДенисенкоМ. В.DenisenkoM. V.РоманкоЮ. С.RomankoYu. S.ФГАОУ ВО Первый МГМУ имени И.М. Сеченова Минздрава России (Сеченовский университет)РоссияSechenov First Moscow State Medical UniversityRussian FederationГБУЗ МО МОНИКИ им. М.Ф. ВладимирскогоРоссияSBHI of MA MRRCI n.a. M.F. VladimirskiyRussian FederationФГАОУ ВО «БФУ им. И. Канта»РоссияImmanuel Kant Baltic Federal UniversityRussian FederationМРНЦ им. А.Ф. Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава РоссииРоссияA. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationRussian FederationФГАОУ ВО Первый МГМУ имени И.М. Сеченова Минздрава России (Сеченовский университет); МРНЦ им. А.Ф. Цыба – филиал ФГБУ «НМИЦ радиологии» Минздрава РоссииРоссияSechenov First Moscow State Medical University; A. Tsyb Medical Radiological Research Centre – branch of the National Medical Research Radiological Centre of the Ministry of Health of the Russian FederationRussian Federation201910072019822530Copyright © Решетов И.В., Фатьянова А.С., Бабаева Ю.В., Гафаров М.М., Огданская К.В., Сухова Т.Е., Коренев С.В., Денисенко М.В., Романко Ю.С., 20192019Решетов И.В., Фатьянова А.С., Бабаева Ю.В., Гафаров М.М., Огданская К.В., Сухова Т.Е., Коренев С.В., Денисенко М.В., Романко Ю.С.Reshetov I.V., Fatyanova A.S., Babaeva Y.V., Gafarov M.M., Ogdanskaya K.V., Suhova T.E., Korenev S.V., Denisenko M.V., Romanko Y.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pdt-journal.com/jour/article/view/316

В настоящее время фотодинамическая терапия (ФДТ) является одним из наиболее эффективных методов лечения актинического кератоза (АК). По мере роста показателей заболеваемости АК, главным образом, из-за популяризации отдыха в странах с повышенной инсоляцией, возрастает интерес к разработке новых и усовершенствованию существующих методов диагностики и лечения. Всё более востребованными становятся исследования, которые направлены на определение конечной эффективности ФДТ с учётом возникших побочных реакций и отдалённых косметических результатов. Природа света, необходимого для возбуждения фотосенсибилизатора (ФС), открывает новые возможности в области экспериментальных исследований, которые направлены на снижение частоты и степени выраженности побочных реакций при аналогичной эффективности применяемой терапии. В обзорной статье приводятся результаты собственных и зарубежных исследований по диагностике и лечению АК за 2017–2019 гг.: определены возможности применения источников с естественным и коротковолновым излучением при различной глубине поражения кожи; представлена классификация роста очагов АК в базальном слое эпидермиса, увеличивающая возможность прогнозирования исходов заболевания; показана превалирующая значимость флуоресцентной диагностики (ФД) по сравнению с традиционными методами обследования; оценены преимущества применения ФДТ с использованием естественного света и искусственных источников облучения; описана возможность использования комбинации препаратов для повышения эффективности ФДТ на участках, плохо поддающихсялечению, и в очагах АК при высокой степени поражения базального слоя эпидермиса. 

Currently, photodynamic therapy (PDT) remains the most effective treatment for actinic keratosis (AK). With the increase in the incidence of AK, mainly due to the popularization of recreation in countries with increased insolation, there is an increasing interest in developing new methods of diagnostics and treatment and improving the existing ones. Studies that are aimed at determining the final efficacy of PDT, taking into account the resulting adverse reactions and long-term cosmetic results, are becoming increasingly popular. The nature of the light needed to excite a photosensitizer (PS) opens up new possibilities in the field of experimental studies that are aimed at reducing adverse reactions with similar efficacy of the applied therapy. In the review article, we presented the results of our own and foreign studies on the diagnosis and treatment of AK for 2017–2019, namely: we determined the possibilities of using sources with natural and short-wave radiation at different depths of skin lesions; presented a classification of the growth of AK in the basal layer of the epidermis, which increases the possibility of predicting the outcomes of the disease; showed the prevailing efficiency of fluorescent diagnostics compared with traditional diagnostic methods; evaluated the advantages of PDT using natural light and artificial sources of radiation; described the possibility of using a combination of drugs to increase the effectiveness of PDT in difficult to treat areas and in AK foci with a high degree of damage to the basal layer of the epidermis. 

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The authors declare that there are no conflicts of interest present.