Premium
Short incubation with methyl aminolevulinate for photodynamic therapy of actinic keratoses
Author(s) -
Braathen LR,
Paredes BE,
Saksela O,
Fritsch C,
Gardlo K,
Morken T,
Frølich KW,
Warloe T,
Solér AM,
Ros AM
Publication year - 2009
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/j.1468-3083.2008.03029.x
Subject(s) - medicine , photodynamic therapy , scalp , lesion , actinic keratosis , keratosis , dermatology , target lesion , outpatient clinic , surgery , myocardial infarction , chemistry , organic chemistry , basal cell , percutaneous coronary intervention
Background Photodynamic therapy (PDT) using methyl aminolevulinate (MAL) is an effective first‐line treatment for actinic keratoses. A reduced incubation period may have practical advantages. Objective This study aims to evaluate the effect of incubation time (1 vs. 3 h), MAL concentration (160 mg/g vs. 80 mg/g) and lesion preparation in the setting of MAL‐PDT for treatment of actinic keratosis (AK). Design Open, randomized, parallel‐group multicentre study. Setting Outpatient dermatology clinics. Subjects One hundred and twelve patients with 384 previously untreated AK. Most lesions (87%) were located on the face and scalp and were thin (55%) or moderately thick (34%). Methods Lesions were debrided, and MAL cream (160 mg/g or 80 mg/g) was applied before illumination with red light (570–670 nm; light dose, 75 J/cm 2 ). Patients were followed up at 2 and 3 months. Sixty patients (54%) were re‐treated and assessed at 6 months. Main outcome Complete lesion response rates 3 and 12 months after last treatment. Results For lesions on the face/scalp, lesion complete response rates were 78% for thin AK and 74% for moderately thick AK lesions after 1 h vs. 96% and 87% after 3 h incubation with MAL 160 mg/g. Lesion recurrence rates at 12 months after two treatments were similar [19% (3 of 16) with 1 h vs. 17% (3 of 18) with 3 h 160 mg/kg MAL‐PDT] and lower than for 80 mg/g MAL‐PDT (44–45%). Conclusion MAL‐PDT using a 1‐h incubation may be sufficient for successful treatment of selected AK lesions. Conflicts of interest Lasse R Braathen consults for Photocure and has received speaker honoraria from Photocure and Galderma. Trond Warloe is a co‐inventor of the corresponding patent and is a minor share holder of Photocure ASA. Tore Morken has been paid as a chairman of a Photocure‐sponsored symposium. Bruno E Paredes, Olli Saksela, Clemens Fritsch, Kerstin Gardlo, Karin W Frölich, Ana M Solér and Ann‐Marie Ros do not have any relevant conflict of interest, financial or otherwise.