Photodynamic therapy for actinic keratosis of the forehead and scalp with the Aktilite <scp>CL</scp> 128: Is there a cut‐off value for Pp<scp>IX</scp>‐weighted irradiance for effective treatment?

Vicentini, C.; Vignion‐Dewalle, Anne‐Sophie; Thecua, Elise; Lecomte, F.; Behal, Hélène; Maire, Cyril; Tylcz, Jean-Baptiste; Rached, Henry Abi; Mortier, Laurent; Mordon, Serge

doi:10.1111/phpp.12457

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…29,30 Vicentini et al thus reported an irradiance ranging from 0Á25 to 60 mW cm À2 and a light dose ranging from 0Á15 to 36 J cm À2 when treating patients with AK of the forehead and scalp. 30,31 Similar results to those achieved with P-PDT, in terms of both efficacy and tolerability, could be obtained with low-irradiance illumination beginning 30 min after applying MAL, provided that homogeneous illumination can be applied over the treatment area for 2Á5 h. This is not the case for most light-emitting diode panels, and in particular for the Aktilite CL 128 lamp as discussed above.…”

Section: Discussionmentioning

confidence: 56%

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The conventional protocol vs. a protocol including illumination with a fabric‐based biophotonic device (the Phosistos protocol) in photodynamic therapy for actinic keratosis: a randomized, controlled, noninferiority clinical study

et al. 2019

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Summary Background Topical photodynamic therapy (PDT) using methyl aminolaevulinate is a noninvasive treatment option suitable to treat clinical and subclinical actinic keratosis (AK) over a large area (field cancerization). The most widely used, conventional protocol in Europe includes illumination with a red‐light lamp. This illumination commonly causes pain, and patients often cannot complete the treatment. Objectives The aims of this paper are twofold. The first aim is to introduce a novel protocol, the Phosistos protocol (P‐PDT), which includes illumination with a fabric‐based biophotonic device. The second and major aim is to assess the noninferiority, in terms of efficacy for PDT of AK, of P‐PDT compared with the conventional protocol (C‐PDT). Methods A randomized, controlled, multicentre, intraindividual clinical study was conducted. Forty‐six patients with grade I–II AK of the forehead and scalp were treated with P‐PDT on one area (280 AK lesions) and with C‐PDT on the contralateral area (280 AK lesions). The primary end point was the lesion complete response (CR) rate at 3 months, with an absolute noninferiority margin of −10%. Secondary end points included pain scores, incidence of adverse effects and cosmetic outcome. Results Three months following treatment, the lesion CR rate of P‐PDT was noninferior to that of C‐PDT (79·3% vs. 80·7%, respectively; absolute difference −1·6%; one‐sided 95% confidence interval −4·5% to infinity). The noninferiority of P‐PDT to C‐PDT in terms of the lesion CR rate remained at the 6‐month follow‐up (94·2% vs. 94·9%, respectively; absolute difference −0·6%; one‐sided 95% confidence interval −2·7% to infinity). Moreover, the pain score at the end of illumination was significantly lower for P‐PDT than for C‐PDT (mean ± SD 0·3 ± 0·6 vs. 7·4 ± 2·3; P < 0·001). Conclusions P‐PDT is noninferior to C‐PDT in terms of efficacy for treating AK of the forehead and scalp and resulted in much lower pain scores and fewer adverse effects. What's already known about this topic? Topical photodynamic therapy using methyl aminolaevulinate is effective for treating actinic keratosis. In Europe, the conventional protocol involves illumination with a red‐light lamp. Unfortunately, pain is often experienced by patients undergoing this protocol. An alternative protocol that uses daylight illumination has recently been shown to be as effective as the conventional protocol while being nearly painless. However, this alternative protocol can be conducted only in suitable weather conditions. What does this study add? The Phosistos protocol is demonstrated to be as effective as the conventional protocol, nearly as painless as the daylight protocols and suitable year round for treatment of actinic keratosis.

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Section: Discussionmentioning

confidence: 56%

“…Vicentini et al . thus reported an irradiance ranging from 0·25 to 60 mW cm −2 and a light dose ranging from 0·15 to 36 J cm −2 when treating patients with AK of the forehead and scalp …”

Section: Discussionmentioning

confidence: 97%

The conventional protocol vs. a protocol including illumination with a fabric‐based biophotonic device (the Phosistos protocol) in photodynamic therapy for actinic keratosis: a randomized, controlled, noninferiority clinical study

et al. 2019

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“…The device is designed to establish treatment thresholds for the individualization of PDT treatment [8]. Light-emitting fabrics have recently emerged as an innovative light source for PDT, delivering a homogenous and reproducible light dose on curved skin surfaces with proven effectiveness against AK, equivalent to conventional PDT, yet nearly painless in use, and capable of use year-round [9][10][11][12]. Dr Abi-Rached, (Lille, France) has evaluated a fabric light source for vulvar Paget disease and is currently assessing it for the treatment of folliculitis decalvans and localized mycosis fungoides [13].…”

Section: Increasing Choice In Pdt Delivery -Home and Simulated Daylig...mentioning

confidence: 99%

Review of the European Society for Photodynamic Therapy (Euro-PDT) Annual Congress 2022

Morton,

Szeimies,

Braathen

2023

European Journal of Dermatology

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This article reviews the 2022 European Society for Photodynamic Therapy (Euro-PDT) Annual Congress. PDT has been investigated for the treatment of a broad number of oncologic, infectious and inflammatory indications. New studies confirm the potential for wider use of topical PDT for acne and photoaging, as well as several uncommon conditions including tinea capitis, Mycobacterium marinum, cutaneous alternariosis, resistant acral warts, eyelid Bowen's disease, mycosis fungoides, pseudolymphoma, and graft-versus-host disease. Hidradenitis suppurativa patients may also benefit from intra-lesional PDT. Several methods of delivering PDT have been validated, including conventional, daylight and artificial daylight PDT. Light-emitting fabrics have emerged as an innovative solution to the delivery of uniform light over the scalp as well as anatomically-challenging sites, with opportunities now to control and monitor these devices via mobile phone applications. Pre-treatment of patients with thicker, more difficult-to-treat actinic keratoses (AK) with calcitriol appears to be a practical approach to increasing efficacy, although this is associated with increased local skin reactions. Sequential treatment of AK and photoaging with daylight-PDT and injectable NASHA gel indicates that these two therapeutic approaches offer complementary effects. Potential biomarkers may help predict responsiveness of patients with field cancerization and AK receiving daylight PDT. Over-expression of the proto-oncogene, Myc, has been observed in poor responders, whilst the tumour suppressor gene, PTEN, showed under-expression. The potential for use and methods of delivery of topical PDT for dermatological indications continue to expand the enhanced choice of treatment offered to patients.

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Efficacy of textile photodynamic therapy for mycosis fungoides

Toulemonde¹,

Douxami²,

Faiz³

et al. 2023

JAAD Case Reports

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Photodynamic therapy for actinic keratosis of the forehead and scalp with the Aktilite CL 128: Is there a cut‐off value for PpIX‐weighted irradiance for effective treatment?

Cited by 5 publications

References 31 publications

The conventional protocol vs. a protocol including illumination with a fabric‐based biophotonic device (the Phosistos protocol) in photodynamic therapy for actinic keratosis: a randomized, controlled, noninferiority clinical study

The conventional protocol vs. a protocol including illumination with a fabric‐based biophotonic device (the Phosistos protocol) in photodynamic therapy for actinic keratosis: a randomized, controlled, noninferiority clinical study

Review of the European Society for Photodynamic Therapy (Euro-PDT) Annual Congress 2022

Efficacy of textile photodynamic therapy for mycosis fungoides

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