Daylight photodynamic therapy as a treatment for for actinic field change in patients diagnosed with Oculocutaneous albinism in Sub-Saharan Africa

Abstract

Abstract Background Oculocutaneous albinism (OCA) is a genetically inherited condition, whereby melanin is reduced or absent in the skin. A lack of melanin predisposes patients to actinic damage and skin malignancies. In Tanzania, a resource-limited country, the treatment of choice for pre-cancerous skin lesions is cryotherapy. Objectives To investigate whether daylight PDT is a safe and well-tolerated treatment for actinic field change in the OCA population in Tanzania. Methods 12 participants with actinic damage were recruited from a Standing Voice skin surveillance clinic and treated with dPDT. Study participants completed tolerability and acceptability questionnaires at day 5 and 3-months post-treatment. A dermatologist assessed clinical response to dPDT at 3 months. Results Daylight PDT was well-tolerated and acceptable to the majority of patients. Actinic damage was reduced by 25-90%. No skin cancers developed during the treatment. Conclusions This pilot study suggests that dPDT is a safe and tolerable treatment for actinic damage in the OCA population in Tanzania. Further work is required to compare the efficacy of dPDT against other topical therapies for actinic field change.