Photodynamic therapy

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 71 KB
• Volume: 39
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.20497

✦ Synopsis

Background and Objective: Combined use of topical 5-aminolevulinic acid (5-ALA) and blue light is an approved photodynamic therapy (PDT) for actinic keratoses (AK). It has been suggested by Strasswimmer that ambient light may activate 5-ALA. The purpose of this study was to assess whether 5-ALA was activated, and AKs were successfully treated, with ambient light alone, as compared to intense pulsed light. Study Design/Materials and Methods: At an academic dermatology practice, enrollment of 15 adult patients with at least 6 AK, at least 3 on each side of the face. Two Levulan Kerasticks (DUSA) were applied to each patient's face and hair-free scalp. One side was randomly assigned to duct tape coverage while the other received intense pulsed light (IPL) (Vasculight, Lumenis). Then the IPL site was covered while the other received irradiation from a Ritter surgical light 18 inches from the face for 45 minutes. Then the treated areas were covered with duct tape for 48 hours. Outcome measures were erythema, edema, crusting, pain, and blinded rater evaluation of photographs at 48 hours and 1 week; and AK counts at 3 weeks. Results: There was no statistically significant difference across the arms in the degree of clearance of AK. Patients noted significantly less discomfort with ambient light compared to IPL (2.6 vs. 4.5/10). In 3 cases, there was linear patterning on the IPL side; no lines occurred with ambient light. Conclusions: For activation of 5-ALA PDT, ambient light delivered by a lamp appears at least as effective and possibly better tolerated than IPL.

84