Locally advanced basal cell carcinoma (laBCC) is an uncommon cutaneous malignant tumor characterized by direct spread and extensive tissue destruction. The optimal therapy for laBCC remains a challenge, especially for elderly patients. Photodynamic therapy (PDT) has its advantage of better tumor selectivity, providing focal treatment for various non-melanoma carcinomas. We report that a new combination treatment of HiPorfin-photodynamic therapy (HiPorfin-PDT) and modified topical 5-aminolevulinic acid-photodynamic therapy (ALA-PDT), named bimodal PDT was successful to treat a 91-year-old patient with laBCC. As for side effects, hypertrophic scar and pain were observed. The symptoms were relieved after intralesional corticosteroid, 980 nm laser and 595 nm pulsed dye laser treatment in 3 months.

Dissecting cellulitis of the scalp (DCS) is difficult to be treated and 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) is considered to be a potential treatment for inflammatory skin diseases.
To analyze the efficacy and safety of ALA-PDT on DCS.
The treatment areas of DCS patients were incubated with freshly prepared 10% ALA for 3 hours. The 633 ± 10 nm light with the intensity of 80-100 mw/cm2 was used as the irradiation source of ALA-PDT, and the irradiation time was 20-30 minutes. Three sessions were applied at an interval of 10-15 days. According to the reduction of lesions and the improvements of patients\' symptoms after each session, the objective assessment of therapeutic effect was divided into four grades. The adverse effects were recorded.
Seven male DCS patients finished the treatments and assessments. One month after three sessions of treatment, one patient recovered, three patients received significant improvement, and one patients received medium improvement. At the 3-month follow-up, two patients recovered, four patients received significant improvement, and one patients received medium improvement. The patients tolerated well to the therapy without any severe adverse effects.
10% ALA-PDT is effective and safe on male DCS patients. As a localized and less invasive treatment, it provides a preferable choice for DCS patients. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.