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Pulse photodynamic therapy reduces inflammation without compromising efficacy in the treatment of multiple mild actinic keratoses of the face and scalp: a randomized clinical trial
Author(s) -
Wiegell S.R.,
Petersen B.,
Wulf H.C.
Publication year - 2016
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.14465
Subject(s) - photodynamic therapy , erythema , scalp , medicine , dermatology , pulse (music) , corticosteroid , lesion , surgery , chemistry , optics , physics , organic chemistry , detector
Summary Background The main side‐effects of photodynamic therapy ( PDT ) for actinic keratoses ( AK s) are post‐treatment erythema and oedema, and pain during illumination. Severe erythema after PDT enhances the down time associated with the treatment. Objectives To evaluate in a randomized intraindividual study whether pulse‐ PDT and corticosteroid pulse‐ PDT would reduce treatment‐induced erythema compared with conventional PDT . Methods Twenty‐two patients with multiple mild AK s on the face and scalp were treated with methyl aminolaevulinate ( MAL )‐ PDT in three similar areas. Two areas were incubated with MAL for 30 min (pulse‐ PDT ) and one area was incubated with MAL for 3 h (conventional PDT ). All areas were illuminated with red light after 3 h. In one of the pulse‐ PDT areas a superpotent corticosteroid was applied before and just after PDT (S‐pulse‐ PDT ). Results Pulse‐ PDT significantly reduced PDT ‐induced erythema ( P = 0·020), and erythema was even further reduced by S‐pulse‐ PDT ( P < 0·001). The complete lesion response rate 3 months after PDT did not differ significantly between the three treated areas. Conclusions Pulse‐ PDT and S‐pulse‐ PDT reduced erythema 24 h after treatment of multiple mild AK s on the face and scalp. The use of a short MAL application time and topical corticosteroid did not affect the efficacy of PDT and may be an easy way to make PDT treatment of large visible areas more acceptable.