Efficacy of Photodynamic Therapy with Methyl 5-aminolevulinic Acid and Red Light for Actinic Keratosis

Suh, Kee Suck; Lee, Jin Woo; Jeon, Young Seung; Kim, Sang Tae

Abstract

BACKGROUND: Actinic keratosis (AK) is a pre-cancerous skin lesion that has the potential to progress to squamous cell carcinoma, which generally occurs on long-term sun exposed and cosmetically sensitive areas of the face, scalp, ears and neck. Many treatment options such as surgical excision, electrosurgery, cryotherapy, topical therapy including 5-fluorouracil, imiquimod and diclofenacare are available for AK, but these can be inconvenient and unsatisfactory for patients. Recently, the efficacy of topical photodynamic therapy (PDT) has been demonstrated in a large number of clinical studies over the last several years.
OBJECTIVE
The aim of this study was to evaluate the efficacy and adverse effects of methyl 5-aminolevulinic acid (MAL) and red light photodynamic therapy (PDT) in the treatment of actinic keratosis.
METHODS
This study included 21 actinic keratosis lesions in 12 patients. After application of commercially available MAL cream (Metvix(R), Galderma, Hertfordshire, U.K.) under occlusion for 3 hours, the lesions were illuminated by red light from a light-emitting diode system (Aktilite lamp(R), PhotoCure ASA, Oslo, Norway). All patients were followed for 3 months after 2 MAL-PDT sessions. Therapeutic effectivenesswas assessed by clinical and histopathological findings.
RESULTS
Complete remission was achieved in 18 of 21 lesions (85.7%). The local adverse effects were erythema, pain, burning sensation and edema.
CONCLUSION
This study showed that MAL-PDT using red-light is a safe and effective treatment option for AK.