Serious side effects of
photodynamic therapy (
PDT) are rare (A.L. Abramson, M.J. Shikowitz, V.M. Mullooly, Clinical effects of
photodynamic therapy on recurrent laryngeal
papillomas, Arch. Otolaryngology Head Neck Surg., 118 (1992) 25-29; A.L. Abramson, M.J. Shikowitz, Clinical exacerbation of
systemic lupus erythematosus after
photodynamic therapy of laryngotracheal
papillomatosis,
Laser Surg. Med., 13 (1993) 677-679). The most frequent side effects of
PDT are hypersensitive skin reactions, local
edema,
nausea, a
metallic taste and liver-toxicity (J. Feyh, E. Kastenbauer, Treatment of
laryngeal papillomatosis with photodynamic
laser therapy, Laryngorhinootologie, 71 (1992) 190-192; J. Feyh, R. Gutmann, A. Leunig, Die Photodynamische Therapie im Bereich der Hals-, Nasen-, Ohrenheilkunde Laryngorhinootologie, 72(6) (1993) 273-78; M.S. Kavuru, A.C. Mekta, Treatment of
recurrent respiratory papillomatosis, N. Engl. J. Med., 326 (1992) 204-205; B.L. Wenig, D.M. Kurtzmann,
Photodynamic therapy in the treatment of
squamous cell carcinomas of the head and neck, Arch. Otolaryngol Head Neck Surg., 116 (1990) 1267-1270). In this case a patient (aged 57 years) suffering from a recurrent larynx
papillomatosis was treated with
PDT. He was sensitized with
Photosan 3 (DHE) 2.5 mg kg-1
body weight, 24 h prior to photoradiation. As a light source, an
argon dye laser, operating at a wavelength of 630 nm was used, coupled with a cylindrical light applicator.
After treatment the patient was admitted to an intensive care unit for 24 h. 3 h after photoradiation, general
urticarial wheals arose, as well as
tachycardia and a decrease in blood pressure followed by all the signs of serious
anaphylaxis. 1.5 h
after treatment with
adrenaline and
cortisone and stabilization of the cardiac and circulatory situation no more skin lesions were visible.