J. Sullivan1,2, P. Sharpe3
Introduction: LADD is a promising new drug delivery technique to enhance the efﬁcacy of local skin treatments. This involves laser pretreatment followed by topical drug application aiming to increase and target the amount of drug that reaches the appropriate skin component to improve treatment efﬁcacy
Method: A review of the pharmacology and literature along with a Case Series is used to illustrate and highlight areas of therapeutic challenge / difﬁcult patient situations
/ along with cosmetic and a growing number of dermato-
logic conditions where LADD could be considered.
Case 1: Laser-Assisted Photodynamic Therapy for Actinic ﬁeld damage (forehead and scalp) resistant to traditional treatment in a high risk area and patient
Case 2: Extensive Paget’s Disease (scrotum and penis) after recurrence following surgery in an elderly man who declined surgery
Case 3: Hypertrophic (and keloidal) scaring due to acne treated with triamcinolone and 5-ﬂuorouracil
Results: Laser-assisted Photodynamic Therapy for actinic keratosis now has a robust evidence base making this a suitable treatment to consider in challenging actinopaths and/or challenging situations. LADD shows both efﬁcacy and aesthetic beneﬁts. Triamcinolone and 5-ﬂuorouracil treatment of hypertrophic scars or treatment-resistant inﬂammatory dermatoses are other promising areas. Many other indications are being explored. Enhanced dermal and potentially systemic absorption also needs to be taken into account from a safety perspective.
Conclusion: LADD is likely to be quickly and increasingly incorporated into standard dermatology practice.