| Autor: |
Togsverd ‐ Bo, K., Lei, U., Erlendsson, A.M., Taudorf, E.H., Philipsen, P.A., Wulf, H.C., Skov, L., Hædersdal, M. |
| Předmět: |
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| Zdroj: |
British Journal of Dermatology; Feb2015, Vol. 172 Issue 2, p467-474, 8p |
| Abstrakt: |
Background Topical photodynamic therapy ( PDT) for actinic keratoses ( AK) is hampered by pain during illumination and inferior efficacy in organ-transplant recipients ( OTR). Objectives We assessed ablative fractional laser (AFL)-assisted daylight photodynamic therapy (PDT) (AFL-d PDT) compared with daylight PDT (d PDT), conventional PDT (c PDT) and AFL alone (AFL) in field treatment of AK in OTR. Methods In each patient, four areas in the same region were randomized to one treatment with AFL-d PDT, d PDT, c PDT and AFL. AFL was delivered with a 2940-nm AFL at 2·3 mJ per pulse, 1·15 W, two stacks, 50-μs pulse-duration, 2·4% density. In d PDT and AFL-d PDT, methyl aminolaevulinate (MAL) was applied for 2·5 h without occlusion during daylight exposure. For c PDT, MAL was occluded for 3 h followed by red-light (630 nm) irradiation at 37 J cm−2. The primary end-point was complete response (CR) 3 months post-treatment. Results Sixteen patients with 542 AK (grades I-III) in field-cancerized skin of the scalp, chest and extremities were treated during August and September 2012. After 3 months, CR (AK I-III) rates were 74% after AFL-d PDT, 46% after d PDT, 50% after c PDT and 5% after AFL ( P < 0·001). CR rates in AFL-d PDT, d PDT and c PDT were also significantly different ( P = 0·004). Median maximal pain scores differed significantly during AFL-d PDT (0), d PDT (0), AFL (0) and c PDT (5) ( P < 0·001). Erythema and crusting were more intense following AFL-d PDT than d PDT and c PDT, but only transient hypopigmentation was observed. Conclusions AFL-d PDT is a novel PDT modality that enhances CR with excellent tolerability compared with d PDT and c PDT in difficult-to-treat AK in OTR. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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