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5-aminolevulinic acid through a needle-free, plum-blossom needle or conventional needle followed by photodynamic therapy are available options for non-melanoma skin cancer treatment. To compare these three techniques of injection of 5-aminolevulinic, regarding treatment response and adverse effects in patients with non-melanoma skin cancer. Non-melanoma skin cancer patients have received six cycles of 0.5 mL intralesional 20% w/v 5-aminolevulinic acid through a conventional needle (CPT cohort,  n  = 158), or plum-blossom needle (BPT cohort,  n  = 118), or needle-free injection (NPT cohort,  n  = 105) followed by irradiation with a red light. Data regarding treatment response and adverse effects were collected and analyzed. The treatment response was higher among patients of NPT cohort than those of CPT ( p  = .012,  q  = 3.981) and BPT ( p  = .012,  q  = 3.472) cohorts. Conventional and plum-blossom needle injections therapies were reported scar, local redness, and worse cosmetic appearance in the follow-up period. Needle-free injection of intralesional 5-aminolevulinic acid followed by irradiation with red light therapy were reported high treatment response with manageable adverse effects for non-melanoma skin cancer patients than that of conventional and plum-blossom needle injections. III.

A retrospective study comparing different injection approaches of 5-aminolevulinic acid in patients with non-melanoma skin cancer