Comparative tolerability and efficacy of daylight, conventional, and combination aminolevulinic acid photodynamic therapy for treatment of actinic keratosis

Crow, Lauren; Saylor, Drew K.; Griffith-Bauer, Kelly; Tello, Tiffany; Aroyan, Christine; Lazar, Ann; Arron, Sarah T.

doi:10.1016/j.jaad.2021.01.031

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…Efficacy was similar at Day 84 with mean AK reductions from baseline being 63.9%, 66.4%, and 61.8% following conventional, combination, and daylight groups, respectively. AK clearance did not correlate with daylight solar irradiance (range 8.5–1122.0 W/m 2 ) 16 …”

Section: Treatment Of Aksmentioning

confidence: 90%

Actinic keratoses: The latest in therapy

Berman

2021

Dermatological Reviews

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The following is a review of the pathogenesis and natural history of actinic keratoses, their progression to squamous cell carcinoma, and recent findings and insights into the mechanisms of action of chemopreventative and field therapeutic agents for actinic keratoses are highlighted. Oral nicotinamide appears to be a safe and tolerable chemopreventative agent although its effectiveness requires continued use. Tirbanibulin ointment 1% is novel in its proposed mechanism of action and requires the shortest period of treatment of currently US Food and Drug Administration-approved, topically applied field therapies for actinic keratoses.

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Section: Treatment Of Aksmentioning

confidence: 90%

Actinic keratoses: The latest in therapy

Berman

2021

Dermatological Reviews

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“…Photosensitizing agents include topical methyl aminolevulinate (MAL), 5-aminolevulinic acid (ALA), or BF-200 ALA, a nanoemulsion-based gel that optimizes epidermal penetration [ 3 ]. While light sources typically include red or blue light, daylight PDT has also been demonstrated to be effective [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy

Curiel‐Lewandrowski

Myrdal

Saboda

et al. 2021

Cancers

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Reflectance confocal microscopy (RCM) presents a non-invasive method to image actinic keratosis (AK) at a cellular level. However, RCM criteria for AK response monitoring vary across studies and a universal, standardized approach is lacking. We aimed to identify reliable AK response criteria and to compare the clinical and RCM evaluation of responses across AK severity grades. Twenty patients were included and randomized to receive either cryotherapy (n = 10) or PDT (n = 10). Clinical assessment and RCM evaluation of 12 criteria were performed in AK lesions and photodamaged skin at baseline, 3 and 6 months. We identified the RCM criteria that reliably characterize AK at baseline and display significant reduction following treatment. Those with the highest baseline odds ratio (OR), good interobserver agreement, and most significant change over time were atypical honeycomb pattern (OR: 12.7, CI: 5.7–28.1), hyperkeratosis (OR: 13.6, CI: 5.3–34.9), stratum corneum disruption (OR: 7.8, CI: 3.5–17.3), and disarranged epidermal pattern (OR: 6.5, CI: 2.9–14.8). Clinical evaluation demonstrated a significant treatment response without relapse. However, in grade 2 AK, 10/12 RCM parameters increased from 3 to 6 months, which suggested early subclinical recurrence detection by RCM. Incorporating standardized RCM protocols for the assessment of AK may enable a more meaningful comparison across clinical trials, while allowing for the early detection of relapses and evaluation of biological responses to therapy over time.

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Principles of Photodynamic Therapy

Ibbotson,

McKenna

2024

Rook's Textbook of Dermatology

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Topical photodynamic therapy (PDT) is widely used as an effective and well‐tolerated treatment for field change actinic keratosis, Bowen disease and superficial basal cell carcinoma. There is a strong evidence base to support its use and guidelines, which summarise the evidence and clinical utility of this therapy. There are also standards available for guidance with respect to establishing PDT services in dermatology and emphasis is placed on the availability of PDT for practitioners affiliated with a skin cancer multi‐disciplinary team. Developments in photosensitisers and light delivery, such as through the increasing application of daylight PDT, have greatly improved the tolerance, acceptability and uptake of PDT, such that this should be widely available through dermatology services. Further refinements in photosensitiser and light delivery will be expected to continue to improve PDT outcomes and the uptake of this invaluable therapeutic approach.

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Comparative tolerability and efficacy of daylight, conventional, and combination aminolevulinic acid photodynamic therapy for treatment of actinic keratosis

Cited by 5 publications

References 4 publications

Actinic keratoses: The latest in therapy

Actinic keratoses: The latest in therapy

In Vivo Reflectance Confocal Microscopy as a Response Monitoring Tool for Actinic Keratoses Undergoing Cryotherapy and Photodynamic Therapy

Principles of Photodynamic Therapy

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