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Is the thin layer of methyl aminolevulinate used during photodynamic therapy sufficient?
Author(s) -
Wiegell Stine R.,
Lerche Catharina M.,
Wulf Hans Christian
Publication year - 2016
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/phpp.12227
Subject(s) - photodynamic therapy , protoporphyrin ix , actinic keratoses , occlusion , fluorescence , medicine , nuclear medicine , dermatology , chemistry , surgery , optics , physics , organic chemistry
Summary Background If the recommended 1.0 mm layer of methyl aminolevulinate ( MAL ) is used during photodynamic therapy ( PDT ) of large areas with multiple actinic keratoses ( AK ) huge amounts of cream are needed. Objectives To report the amount of MAL used for PDT of AK and basal cell carcinomas ( BCC ) in daily routine. The association of protoporphyrin IX (Pp IX ) fluorescence and thickness of MAL was investigated in a randomized paired study in healthy volunteers. Methods Amount of cream used per cm 2 during conventional and daylight PDT was recorded. In 16 healthy volunteers, 0.1 mm, 0.2 mm, 0.5 mm and 1.0 mm MAL cream were applied for 3 h on tape‐stripped areas on each forearm randomized to light‐permeable or light‐impermeable occlusion. Pp IX fluorescence was measured. Results Less than 0.4 mm MAL was used during PDT of BCC and 0.2 mm for AK . No difference in Pp IX fluorescence was found between the different thicknesses of MAL using light‐impermeable occlusion. Conclusion In daily routine <0.4 mm MAL was used during PDT of BCC and 0.1–0.2 mm MAL during PDT of AK . The recommended 1.0 mm MAL did not result in a higher accumulation of Pp IX compared to thinner MAL layers after light‐impermeable occlusion for 3 h.