The application of ALA photodynamic fluorescence combined with dermatoscopy in the diagnosis of facial cancerization

Objective To explore the application of ALA photodynamic fluorescence combined with dermatoscopy in the diagnosis of facial cancerization and precancerous lesions. Methods From March 2022 to March 2024, a total of 52 patients with actinic keratosis, BOWEN's disease, squamous cell carcinoma and basal cell carcinoma were enrolled at the dermatology clinic of the First Affiliated Hospital of Henan University of Science and Technology. Each patient was examined by naked eye and ALA photodynamic fluorescence, and the difference in area was compared between these two methods. The ALA photodynamic fluorescence area was divided into 8 equal sections, followed by examination with a dermatoscope to determine whether there were cancerization and precancerous lesions. The lesion area and severity were scored. Results The ALA photodynamic fluorescence area was larger than that observed by the naked eye (all P<0.001). Dermatoscopic examination of the ALA photodynamic fluorescence imaging area revealed precancerous features of various areas and severity, with cancerous area and severity scores of 4.55±1.21, 5.45±2.42, 6.64±2.84, and 5.27±1.95, respectively. Conclusions ALA-photodynamic fluorescence combined with dermatoscopy can find cancerization and precancerous lesions that can't be detected by naked eyes, providing a new method for early screening and early diagnosis of skin cancerization and precancerous lesions.