Three‐step irradiance schedule versus two‐step irradiance schedule for pain control during topical 5‐aminolevulinic acid‐photodynamic therapy of facial acne in Chinese patients: A prospective randomized comparative study

Wu, Huiqiong; Liu, Yongbin; Cui, Liang; Xu, Guijuan; Sun, Xiaodong

doi:10.1002/lsm.23464

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Among 2461 potential studies, 206 satisfied the inclusion criteria (eFigure in the Supplement). Among included trials, 163 (79%) were for acne and 43 (21%) were for rosacea. Rosacea RCTs were more likely to include at least 1 PROM (67% [n = 29 of 43]) compared with acne RCTs…”

Section: Resultsmentioning

confidence: 99%

Use of Patient-Reported Outcomes in Acne Vulgaris and Rosacea Clinical Trials From 2011 to 2021

Miller

Tong

et al. 2022

JAMA Dermatol

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ImportanceAcne and rosacea have substantial implications for quality of life, and it is therefore important to ensure the patient’s voice is being captured in pivotal randomized clinical trials (RCTs). Although patient-reported outcome measures (PROMs) are a valuable tool to capture the patient perspective, little is known about use of PROMs in RCTs on acne and rosacea.ObjectiveTo characterize the use of PROMs in RCTs on acne and rosacea.Evidence ReviewA systematic literature search was conducted using the search terms acne vulgaris and rosacea in the following databases: MEDLINE through PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. A modified search hedge for RCTs from the McGill Library was applied. All phase 2, 3, and 4 RCTs published between December 31, 2011, through December 31, 2021, that evaluated the efficacy and safety of therapies for acne and rosacea vs any comparator were eligible for inclusion.FindingsA total of 2461 publications describing RCTs were identified, of which 206 RCTs met the inclusion criteria (163 trials [79%] on acne and 43 [21%] on rosacea). At least 1 PROM was used in 53% of trials (110) included; PROM use was more common in rosacea RCTs (67% [n = 29]) compared with acne RCTs (50% [n = 81]). At least 1 dermatology-specific (13% [n = 27]) or disease-specific (14% [n = 28]) PROM was included in the RCTs analyzed. Only 7% of trials (14) included a PROM as a primary outcome measure. There was no statistically significant increase in PROM inclusion over the study period (11 of 21 trials in 2011 vs 5 of 12 trials in 2021).Conclusions and RelevanceIn this systematic review, PROMs were included in approximately one-half of acne and rosacea RCTs performed over the study period. In addition, PROMs were rarely used as a primary outcome measure, and inclusion of PROMs has not increased substantially over the past 10 years. Increasing use of PROMs in RCTs can ensure that the patient’s perspective is captured during the development of new treatments for acne and rosacea.

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Section: Resultsmentioning

confidence: 99%

Use of Patient-Reported Outcomes in Acne Vulgaris and Rosacea Clinical Trials From 2011 to 2021

Miller

Tong

et al. 2022

JAMA Dermatol

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“…99 A 3-step irradiance schedule for ALA-PDT had similar acne clearance rates but significantly reduced pain (Visual Analogue Scale 1.61 vs 3.14; P < .0001) compared to a 2-step irradiance schedule with the same total irradiance dose of 84 J/cm 2 . 100 A comparative RCT found that ALA-PDT resulted in superior clearance rates of inflammatory acne lesions compared to IPL or blue-red LED light-based therapies (92% vs 58% or 44%; P < .01). 101 In a RCT of patients with moderate inflammatory facial acne, 2 sessions of ALA-PDT performed 2 weeks apart significantly reduced inflammatory lesions (84% vs 74%; P = .02) and total lesions (79% vs 67%; P = 0.026) at 12 weeks compared to patients that received daily oral doxycycline 100 mg and 0.1% adapalene gel.…”

Section: Acne Vulgarismentioning

confidence: 99%

“…Acne vulgaris PDT ↑ CR of inflammatory acne lesions compared to IPL or blue-red light-emitting diode phototherapy. 100 RCT ALA-PDT ↑ CR of inflammatory and total acne lesions compared to oral doxycycline and adapalene gel. 101…”

Section: Rctmentioning

confidence: 99%

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A Review of the Dermatologic Clinical Applications of Topical Photodynamic Therapy

Luo,

Bose,

Bawazir

et al. 2024

J Cutan Med Surg

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Topical photodynamic therapy is a widely approved therapy for actinic keratoses and low-risk nonmelanoma skin cancers with a rapidly growing range of emerging indications for other cutaneous diseases. This review summarizes the best-available evidence to provide a clinical update for dermatologists on the approved and emerging indications of photodynamic therapy. The body of evidence suggests that photodynamic therapy is superior or noninferior to other available treatment modalities for actinic keratoses, low-risk basal cell carcinomas, Bowen’s disease, skin field cancerization, chemoprevention of keratinocyte carcinomas in organ transplant recipients, photoaging, acne vulgaris, and cutaneous infections including verrucae, onychomycosis, and cutaneous leishmaniasis. There is emerging evidence that photodynamic therapy plays a role in the management of actinic cheilitis, early-stage mycosis fungoides, extramammary Paget disease, lichen sclerosis, and folliculitis decalvans but there are no comparative studies with other active treatment modalities. Common barriers to topical photodynamic therapy include procedural pain, costs, and the time required for treatment delivery. There is significant heterogeneity in the photodynamic therapy protocols reported in the literature, including different photosensitizers, light sources, number of treatments, time between treatments, and use of procedural analgesia. Topical photodynamic therapy should be considered in the management of a spectrum of inflammatory, neoplastic, and infectious dermatoses. However, more comparative research is required to determine its role in the treatment algorithm for these dermatologic conditions and more methodological research is required to optimize photodynamic therapy protocols to improve the tolerability of the procedure for patients.

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“…If a small amount of liquid is inadvertently applied to the mucosal area, the photosensitizer must be removed thoroughly after bandaging in order to reduce residue as well as avoid postoperative redness and pain. 7 (3) Postoperative skin nursing: Immediate postoperative skin reactions include erythema and swelling. In the present study, medical cold compresses containing hyaluronic acid or antibiotic peptides were applied to the patients' faces and intermittently ice-packed for 30-60 min using a cold spray machine.…”

Section: The Observation Groupmentioning

confidence: 99%

Topical ALA-Photodynamic Therapy Combined with Acne Debridement and Meticulous Nursing for the Treatment of Moderate–Severe Acne in Adolescent Patients

Ren¹,

Bao²,

Qian³

et al. 2021

CCID

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Objective The present study aims to explore the effect of acne debridement + meticulous nursing on 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in adolescent patients with moderate–severe acne. Methods A total of 60 adolescent patients with moderate–severe acne who were admitted to our plastic surgery outpatient clinic between January 2018 and January 2020 were selected as the subjects of the present retrospective study. The patients were divided into two groups: the observation group and the control group (n = 30, each). Patients in the control group were treated with standardized ALA-PDT and conventional nursing, while patients in the observation group were treated with ALA-PDT and acne debridement + meticulous nursing intervention. The treatment’s therapeutic effect, adverse reaction incidence, and patient satisfaction 6 months after treatment were compared between the two groups. Results The acne debridement + meticulous nursing effectiveness was 86.7% in the observation group and 60% in the control group, and the adverse reaction incidence was 20% in the observation group and 46.7% in the control group. There existed statistically significant differences in the above-stated indicators between the two groups (p < 0.05). The difference in the visual analogue scores (VASs) for pain, which were measured immediately after the operations, between the two groups was not statistically significant (p > 0.05); however, the respective VAS differences between the two groups at 30 min and 60 min after the operation were statistically significant (p < 0.05). There was a statistically significant difference in patient satisfaction between the two groups (p < 0.05). Conclusion In adolescent patients with ALA-PDT-treated moderate–severe acne, the application of acne debridement + meticulous nursing could improve the clinical treatment efficacy and patient comfort as well as reduce the adverse reaction incidence. For these reasons, the treatment method could be worth promoting in clinical practice.

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Three‐step irradiance schedule versus two‐step irradiance schedule for pain control during topical 5‐aminolevulinic acid‐photodynamic therapy of facial acne in Chinese patients: A prospective randomized comparative study

Cited by 4 publications

References 22 publications

Use of Patient-Reported Outcomes in Acne Vulgaris and Rosacea Clinical Trials From 2011 to 2021

Use of Patient-Reported Outcomes in Acne Vulgaris and Rosacea Clinical Trials From 2011 to 2021

A Review of the Dermatologic Clinical Applications of Topical Photodynamic Therapy

Topical ALA-Photodynamic Therapy Combined with Acne Debridement and Meticulous Nursing for the Treatment of Moderate–Severe Acne in Adolescent Patients

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