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Friday
Oct172008

Efficacy of 3 different light doses in the treatment of actinic keratosis with 5-aminolevulinic acid photodynamic therapy.

Efficacy of 3 different light doses in the treatment of actinic keratosis with 5-aminolevulinic acid photodynamic therapy: a randomized, observer-blinded, intrapatient, comparison study.

J Am Acad Dermatol.  2005; 53(5):823-7 (ISSN: 1097-6787)

Radakovic-Fijan S; Blecha-Thalhammer U; Kittler H; Hönigsmann H; Tanew A
Division of Special and Environmental Dermatology, Medical University of Vienna, Vienna, Austria.

BACKGROUND: Topical 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) has been established in recent years as an effective treatment for disseminated actinic keratosis (AK). As yet, however, data are lacking to define the optimal light dose for activation of ALA-induced protoporphyrin IX in AK.

OBJECTIVE: In the present study our purpose was to compare the efficacy and tolerability of 3 different doses of red light for ALA-PDT of AK. METHODS: Twenty-seven patients with at least 3 clearly definable, mild or moderate AKs on the scalp or face entered the study. After occlusion for 4 hours with 20% ALA, one AK each was irradiated at random with a single dose of 70, 100, or 140 J/cm2. PDT-induced pain was assessed by the patients by means of a visual analog scale that graded pain intensity between 0 and 10. Follow-up examinations were performed 1 and 3 months after PDT.

RESULTS: One month after PDT, the rate of complete remission (CR) was 89% for 70 J/cm2, 92% for 100 J/cm2, and 81% for 140 J/cm2. The CR rates at 3 months were 81% for 70 J/cm2, 77% for 100 J/cm2, and 69% for 140 J/cm2. No significant difference in therapeutic efficacy was found among the 3 light doses at either 1 month (P = .36) or 3 months (P = .96) after PDT. The degree of PDT-induced pain during irradiation was substantial and not statistically different (P = .06) for all 3 light doses.

LIMITATIONS: The conclusions from this study are limited by the small sample size and only apply to topical ALA-PDT.

CONCLUSION: Our results indicate that a red light dose of 70 J/cm2 may be sufficient for effective topical ALA-PDT of disseminated, mild to moderate AK on the face and scalp.

References (1)

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Reader Comments (5)

What does 70 j/cm2 mean? Is this 5 minutes under the light or 1 hour under the light?
What was the source of red light? Was is LED?

11.6 | Unregistered CommenterDr. Dum

I found the 420 nm wavelength light exposure (BLU-U) more effective on treating AK's than any of the settings of an IPL device. There was very little pain associated with this treatment.

Any new methods of treating actinic keratosis? Has anybody ever tried 20% trichloroacetic acid peel?

06.20 | Unregistered CommenterEGrand

EGrand, yes, you should try TCA peels. Personally, lasers aren't that effective in treating AKs. Aside from that, laser treatments are very expensive. If you got money to burn, why not?

07.2 | Unregistered Commentermelinda

cryo has worked well for me.

07.5 | Unregistered Commenterdonell

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