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Background: Photodynamic therapy (PDT) is a novel noninvasive dermatological therapy that has been used together with topical application of 5-aminolevulinic acid (ALA) to treat non-melanoma skin cancers and non-oncological diseases. Multicenter randomized controlled studies have now demonstrated high efficacy of PDT in actinic keratoses and Bowen’s disease. However, it seemed possible that topical PDT would be less effective in brown-skinned individuals, including Japanese, than in white Caucasians.Aim: Establish a standard treatment modality of ALA-PDT in Japanese patients in order to evaluate and improve the effects of PDT in the treatment of actinic keratoses and Bowen’s disease.Materials: A total of 152 lesions of actinic keratoses and 48 lesions of Bowen’s disease in Japanese patients were treated with ALA-PDT using our protocol.Methods: Lesions were treated in three sessions, one week apart, with 50J/cm2 irradiation in each session for a total dose of 150J/cm2 in actinic keratoses, and 100J/cm2 irradiation in each session for a total dose of 300J/cm2 in Bowen’s disease.Results: We achieved overall complete response rates of 81.6% (124/152 lesions) in total actinic keratoses, especially 87.2% (109/125 lesions) for lesions on the face/scalp, and 75.0 % (36/48 lesions) in Bowen’s disease, especially 88.9% (8/9 lesions) for lesions on the trunk. We have also treated non-oncological diseases, such as recalcitrant warts, cutaneous sarcoidosis and other diseases with ALA-PDT with satisfactory outcomes.Conclusions: The ALA-PDT according to our protocol was very successful in the treatment of Japanese patients with actinic keratoses or Bowen’s disease. A therapeutical benefit of PDT is evident in inflammatory and other dermatoses.

CLINICAL RESPONSES TO TOPICAL PHOTODYNAMIC THERAPY OF ACTINIC KERATOSES, BOWEN'S DISEASE AND NON-ONCOLOGICAL DISEASES IN JAPAN