Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study
| Autor: | T. Forschner, Gregor B.E. Jemec, Toomas Talme, Henrik Sølvsten, Alexander Kapp, Stephen Keohane, John T. Lear, Ann-Marie Wennberg, Cato Mork, Berit Berne, Eidi Christensen, Bo Stenquist, Eggert Stockfleth |
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| Předmět: |
Adult
Male medicine.medical_specialty Randomization Administration Topical medicine.medical_treatment Cryotherapy Organ transplantation law.invention Methyl aminolevulinate Randomized controlled trial law medicine Humans Aged Hypopigmentation Transplantation Photosensitizing Agents business.industry Aminolevulinic Acid Keratosis Organ Transplantation Middle Aged Surgery Europe Treatment Outcome medicine.anatomical_structure Photochemotherapy Scalp Female medicine.symptom business Immunosuppressive Agents medicine.drug |
| Zdroj: | University of Copenhagen |
| Popis: | Background. Organ transplant recipients on long-term immunosuppressive therapy are at increased risk of non-melanoma skin lesions. Repeated field photodynamic therapy using topical methyl aminolevulinate (MAL) may have potential as a preventive treatment. Methods. This open randomized, intrapatient, comparative, multicenter study included 81 transplant recipients with 889 lesions (90% actinic keratoses (AK) ]. In each patient, the study treatment was initially administered to one 50 cm 2 area on the face, scalp, neck, trunk, or extremities (n=476 lesions) twice (1 week apart), with additional single treatments at 3, 9, and 15 months. On each occasion, the area was debrided gently and MAL cream (160 mg/g) applied for 3 hr, before illumination with noncoherent red light (630 nm, 37 J/cm 2 ). The control, 50 cm 2 area (n=413 lesions) received lesion-specific treatment (83% cryotherapy) at baseline and 3, 9, and 15 months. Additionally, all visible lesions were given lesion-specific treatment 21 and 27 months in both treatment and control areas. Results. At 3 months, MAL photodynamic therapy significantly reduced the occurrence of new lesions (65 vs. 103 lesions in the control area; P=0.01), mainly AK (46% reduction; 43 vs. 80; P=0.006). This effect was not significant at 27 months (253 vs. 312; P=0.06). Hypopigmentation, as assessed by the investigator, was less evident in the treatment than control areas (16% vs. 51% of patients; P |
| Databáze: | OpenAIRE |
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