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Journal of Environmental Pathology, Toxicology and Oncology

Impact factor: 1.246

ISSN Print: 0731-8898
ISSN Online: 2162-6537

Journal of Environmental Pathology, Toxicology and Oncology

DOI: 10.1615/JEnvironPatholToxicolOncol.v26.i4.60
pages 295-303

A Clinical Investigation to Determine the Effect of Pressure Injection on the Penetration of Topical Methyl Aminolevulinate into Nodular Basal Cell Carcinoma of the Skin

S. M. Campbell
Cornwall Dermatology Research, Peninsula Medical School, Truro, UK TR1 3HD
Andrew Pye
Cornwall Dermatology Research, Peninsula Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK TR1 3HD
S. Horton
Cornwall Dermatology Research, Peninsula Medical School, Truro, UK TR1 3HD
J. Matthew
Cornwall Dermatology Research, Peninsula Medical School, Truro, UK TR1 3HD
P. Helliwell
Cornwall Dermatology Research, Peninsula Medical School, Truro, UK TR1 3HD
Alison Curnow
Cornwall Dermatology Research, Peninsula Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, UK TR1 3HD

ABSTRACT

This investigation considered a novel method of enhancing penetration of the topical photosensitizing agent methyl aminolevulinate (MAL) into nodular basal cell carcinomas (BCCs) using an oxygen pressure injection device. Oxygen pressure injection (OPI) is a method to drive compounds into skin using pressured oxygen. The study was an observer-blinded pilot of a single application of MAL to nBCCs, with or without the use of OPI. The BCCs were then excised at different time intervals (0−180 min) and the depth of penetration of the MAL examined using microscopic fluorescence photometry to detect the production of the naturally fluorescent active photosensitiser protoporphyrin IX (PpIX). A highly selective and homogeneous distribution of MAL-induced porphyrin fluorescence was seen in all nBCC tumors studied, and showed a high lesion-to-normal-tissue ratio with very little fluorescence in the surrounding normal tissue. Although it was difficult to compare quantitatively, as individual tumors in each of the different study groups varied, a definite trend of increase in relative tumor concentration of MAL-induced PpIX was observed over time, and this was enhanced when OPI was employed.