96567 Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day

Name of the Procedure:

• Photodynamic Therapy (PDT)
• Also known as Photodynamic Treatment

Summary

Photodynamic Therapy (PDT) is a treatment used to eliminate premalignant lesions on the skin and adjacent mucosa. It involves the application of a photosensitive drug to the affected area followed by exposure to a specific wavelength of light, which activates the drug, targeting and destroying abnormal cells.

Purpose

• Condition Addressed: Premalignant skin lesions and adjacent mucosal lesions.
• Goals: The primary goal is to destroy precancerous cells to prevent them from developing into malignant cancer. Expected outcomes include the reduction or complete elimination of these cells, thereby lowering cancer risk.

Indications

• Presence of precancerous skin lesions such as actinic keratosis.
• Leucoplakia or other similar conditions affecting the adjacent mucosa.
• Suitable for patients with superficial skin lesions that are accessible to topical treatment.

Preparation

• Pre-procedure Instructions: Patients may be advised to avoid sun exposure and certain medications that increase photosensitivity. Cleaning the area to be treated is necessary.
• Diagnostic Tests: A thorough skin examination, and possibly a biopsy, to confirm the nature of the lesions.

Procedure Description

1. Application of Photosensitive Drug: The area of skin or mucosa with the lesion is cleaned, and a photosensitive drug is applied.
2. Incubation Period: The drug is allowed to be absorbed by the abnormal cells for a specific duration, usually a few hours, depending on the drug used.
3. Illumination/Activation: The treated area is then exposed to a specific wavelength of light, activating the drug.
4. Destruction of Lesions: The activated drug initiates a reaction that destroys the premalignant cells.
   • Tools and Equipment: Photosensitizing drugs, specialized light sources (LEDs, lasers).
   • Anesthesia: Local anesthesia may be used to minimize discomfort.

Duration

The procedure typically takes about 1 to 3 hours, including the incubation period.

Setting

PDT is usually performed in an outpatient setting, such as a dermatology clinic or a hospital outpatient department.

Personnel

• Dermatologist or trained healthcare provider.
• Nursing staff for assistance and patient care.

Risks and Complications

• Common Risks: Redness, swelling, and discomfort at the treated site.
• Rare Risks: Infection, scarring, or changes in skin pigmentation.
• Management: Risks are generally managed with post-procedure care and follow-up assessments.

Benefits

• Non-invasive treatment with minimal downtime.
• Effective in destroying premalignant lesions, reducing cancer risk.
• Rapid recovery and return to normal activities.

Recovery

• Post-procedure Care: Protect the treated area from sunlight and follow any specific care instructions provided by the healthcare provider.
• Recovery Time: Typically a few days to a week, depending on individual healing.
• Restrictions/FU: Avoid sun exposure and follow-up appointments to monitor healing and treatment effectiveness.

Alternatives

• Other Options: Cryotherapy, chemical peels, surgical excision.
• Pros and Cons: Alternatives might involve more extensive procedures with different recovery profiles and potential for greater scarring.

Patient Experience

• During the Procedure: Minor discomfort, akin to a stinging or burning sensation when the light is applied.
• After the Procedure: Redness and sensitivity similar to mild sunburn, managed with prescribed topical ointments and pain relievers if necessary.