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Primary Prevention of Skin Dysplasia in Renal Transplant Recipients With Photodynamic Therapy: A Randomized Controlled Trial
Author(s) -
TogsverdBo K.,
Omland S. H.,
Wulf H. C.,
Sørensen S. S.,
Hædersdal M.
Publication year - 2015
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.13358
Subject(s) - medicine , actinic keratosis , photodynamic therapy , skin cancer , dysplasia , field cancerization , dermatology , randomized controlled trial , keratosis , transplantation , surgery , basal cell , cancer , chemistry , organic chemistry
Organ transplant recipients (OTRs) are at high risk of developing cutaneous squamous cell carcinoma (SCC); prevention includes early treatment of premalignant actinic keratosis (AK). Photodynamic therapy (PDT) is a noninvasive field therapy that reduces new AKs in patients with existing AK and delays SCC development in mice. We investigated the effect of repeated PDT over 5 years for primary prophylaxis of skin dysplasia. These data represent an interim analysis of an on‐going randomized controlled trial. During 2008–2011, 25 renal transplant recipients with clinically normal skin were randomized to split‐side PDT of the face, forearm and hand, the contralateral side serving as untreated control. Patients received PDT on inclusion and at 6‐monthly intervals for 5 years. Blinded evaluation was performed at each visit. We found that prophylactic PDT significantly delayed onset of AK compared with untreated skin, p = 0.020. At 3‐year follow‐up, we observed AK in 63% of patients in untreated skin areas compared with 28% of patients in PDT‐treated skin, with a total number of cumulated AKs in untreated skin (n = 43) compared with PDT‐treated skin (n = 8), p = 0.005. These preliminary data indicate a novel approach to early prevention of skin dysplasia that may reduce morbidity from multiple AKs and SCCs in OTR.