A pilot study to assess the efficacy of photodynamic therapy for Japanese patients with actinic keratosis in relation to lesion size and histological severity

Nakano, Aki; Tamada, Yasuhiko; Watanabe, Daisuke; Ishida, Natsuko; Yamashita, Noriko; Kuhara, Tomoe; Yanagishita, Takeshi; Kawamura, Chiharu; Akita, Yoichi; Matsumoto, Yoshinari

doi:10.1111/j.1600-0781.2009.00401.x

Cited by 22 publications

(29 citation statements)

References 16 publications

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“…Previous studies on MAL-PDT have shown complete response rates of 69% to 92% for AKs on the face and scalp of Caucasian populations10,14,15,16,17. To date, there have been insufficient studies on dark-skinned ethnic groups that have demonstrated the efficacy of ALA-PDT for AKs18,19,20,23. Nakano et al18 showed that ALA-PDT is useful for the treatment of AKs in Asians, and its efficacy might depend on the lesion size and histopathological severity.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there have been insufficient studies on dark-skinned ethnic groups that have demonstrated the efficacy of ALA-PDT for AKs18,19,20,23. Nakano et al18 showed that ALA-PDT is useful for the treatment of AKs in Asians, and its efficacy might depend on the lesion size and histopathological severity. However, several treatment sessions (3~6) are needed to achieve a similar efficacy as in Caucasians, and 2 other studies on ALA-PDT reported that its efficacy was 73% to 82%19,23.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies showed that the efficacy of ALA-PDT in Asian patients was similar to that in Caucasian patients18,19,20,23. However, higher light doses, longer irradiation times, and several treatment sessions were required because melanin absorbs the light intended for protoporphyrin IX (PpIX) in dark skin types18,19,20,23. Because there are differences in the long-term efficacy and safety of PDT between Asian and Caucasian populations, data obtained from Caucasians cannot necessarily be applied to the Asian population.…”

Section: Introductionmentioning

confidence: 86%

“…However, there are insufficient data about the efficacy of either PDT modality for multiple AKs in dark-skinned ethnic groups18,19,20,21,22,23. Furthermore, few studies have evaluated the efficacy of ALA-PDT with a long-term follow-up period in Asian populations23.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, few studies have evaluated the efficacy of ALA-PDT with a long-term follow-up period in Asian populations23. Previous studies showed that the efficacy of ALA-PDT in Asian patients was similar to that in Caucasian patients18,19,20,23. However, higher light doses, longer irradiation times, and several treatment sessions were required because melanin absorbs the light intended for protoporphyrin IX (PpIX) in dark skin types18,19,20,23.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Study of Photodynamic Therapy with Topical Methyl Aminolevulinate versus 5-Aminolevulinic Acid for Facial Actinic Keratosis with Long-Term Follow-Up

Kim

Song

2014

Ann Dermatol

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BackgroundFew studies have compared the efficacy, cosmetic outcomes, and adverse events between 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT) for actinic keratoses (AKs) in Asian ethnic populations with dark-skin.ObjectiveWe retrospectively compared the long-term efficacy, recurrence rates, cosmetic outcomes, and safety of ALA-PDT versus MAL-PDT for facial AKs in Koreans.MethodsA total of 222 facial AKs in 58 patients were included in this study. A total of 153 lesions (29 patients) were treated with 5-ALA, and 69 lesions (29 patients) with MAL. ALA and MAL creams were applied for 6 hours and 3 hours, respectively; the lesions were then illuminated with a halogen lamp at 150 J/cm2 for ALA-PDT and a diode lamp at 37 J/cm2 for MAL-PDT.ResultsThe complete response rates of ALA-PDT and MAL-PDT were 56.9% and 50.7%, respectively, with no significant difference at 12 months after treatment. No significant difference in recurrence rates was observed between the 2 PDT modalities at either 6 or 12 months after treatment. There was no significant difference in the cosmetic outcomes between the 2 treatment modalities at 12 months after PDT. However, ALA-PDT caused significantly more painful than MAL-PDT (p=0.005). The adverse events were mild to moderate, transient, and self-limiting for both modalities.ConclusionMAL-PDT was similar to ALA-PDT in terms of long-term efficacy, recurrence rates, cosmetic outcomes, and adverse events; however, it was a significantly less painful procedure than ALA-PDT in our study.

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