Variable pulsed light is less painful than light-emitting diodes for topical photodynamic therapy of actinic keratosis: a prospective randomized controlled trial

Babilas, Philipp; Knobler, Robert; Hummel, Scott L.; Gottschaller, C.; Maisch, Tim; Koller, Michael; Landthaler, Míchael; Szeimies, Rolf‐Markus

doi:10.1111/j.1365-2133.2007.07959.x

Cited by 98 publications

(59 citation statements)

References 41 publications

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“…Following this, another split-face study (n=13) reported similar results, with improved appearance of crow’s feet (55% versus 29.5%), tactile skin roughness (55% versus 29.5%), mottled hyperpigmentation (60.3% versus 37.2%), and telangiectasias (84.6% versus 53.8%) in the ALA-IPL group 169. A major advantage of IPL compared with irradiation with a light-emitting diode is less time expenditure and less painful effects of heat delivery due to shorter intense exposure times 170. Clinicians should be aware that heat delivered by IPL may cause destruction of hair follicles, so it should be used with caution, especially in men with facial hair.…”

Section: Pdt In Proliferative Diseasementioning

confidence: 99%

Current evidence and applications of photodynamic therapy in dermatology

Wan¹,

Lin²

2014

CCID

117

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In photodynamic therapy (PDT) a photosensitizer – a molecule that is activated by light – is administered and exposed to a light source. This leads both to destruction of cells targeted by the particular type of photosensitizer, and immunomodulation. Given the ease with which photosensitizers and light can be delivered to the skin, it should come as no surprise that PDT is an increasingly utilized therapeutic in dermatology. PDT is used commonly to treat precancerous cells, sun-damaged skin, and acne. It has reportedly also been used to treat other conditions including inflammatory disorders and cutaneous infections. This review discusses the principles behind how PDT is used in dermatology, as well as evidence for current applications of PDT.

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Section: Pdt In Proliferative Diseasementioning

confidence: 99%

Current evidence and applications of photodynamic therapy in dermatology

Wan¹,

Lin²

2014

CCID

117

View full text Add to dashboard Cite

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“…Babilas et al 2007 (Table II) reported less pain with a variable pulsed light (VPL) device as compared with a light emitting diode (LED) system in MAL-PDT 39 . Of interest, the VPL device used a higher light dose (80 J/cm 2 ) than the LED (37 J/cm 2 ), but with a short pulse duration of 5 ms (total pulse time 355 ms) rather than continuous delivery.…”

Section: Factors Contributing To Pain Associated With Pdtmentioning

confidence: 99%

Pain associated with aminolevulinic acid-photodynamic therapy of skin disease

Warren

Karai

Vidimos

et al. 2009

Journal of the American Academy of Dermatology

119

101

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Background Pain during topical aminolevulinic acid (ALA) mediated photodynamic therapy (PDT) limits the use of this treatment of skin diseases. Objective To summarize the effectiveness of interventions to reduce ALA-PDT related pain, and to explore factors contributing to pain induction. Methods A PubMed search was performed to identify all clinical PDT trials (2000–2008) that used ALA or methyl-ALA, enrolled at least 10 patients per trial, and used a semiquantitative pain scale. Results 43 papers were identified for review. Pain intensity is associated with lesion size and location and can be severe for certain diagnoses, such as plaque-type psoriasis. Results are inconsistent for the correlation of pain with light source, wavelength of light, fluence rate, and total light dose. Cooling represents the best topical intervention. Limitations Pain perception differs widely between patients and can contribute to variability in the reported results. Conclusion GABA receptors, cold/ menthol receptors (TRPM8), and vanilloid/capsaicin receptors (TRPV1) may be involved in pain perception during ALA-PDT and are therefore worthy of further investigation.

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“…It has been shown that pain intensity depends on the localization [2,3], size [3,4,5], histological type [4], redness [5] and protoporphyrin IX (PpIX) fluorescence [6] of the treated lesion. Also different light sources [7,8,9], fluence rates [6] and photosensitizing agents [10,11] affect the pain additionally.…”

Section: Introductionmentioning

confidence: 99%

Treatment with 5-Aminolaevulinic Acid Methylester Is Less Painful than Treatment with 5-Aminolaevulinic Acid Nanoemulsion in Topical Photodynamic Therapy for Actinic Keratosis

et al. 2011

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Background: Topical photodynamic therapy (PDT) is an excellent treatment option for actinic keratosis (AK). Pain is one of the major adverse effects. Objective: To compare the pain intensity during the extensive treatment of cosmetic units using 5-aminolaevulinic acid methylester (MAL) or 5-aminolaevulinic acid nanoemulsion (BF-200-ALA). Methods: 173 patients with 965 treated areas were enrolled in this retrospective monocentric study. All patients had multiple AKs and received an extensive treatment of the photodamaged area. 424 areas were treated with MAL and 541 with BF-200-ALA. Pain was rated using a standardized visual analogue scale (VAS). The number of PDT treatment interruptions was documented. Results: PDT with MAL led to a lower mean VAS score (5.0 vs. 5.8), a lower number of treatment interruptions (13.2 vs. 19.9%) and a lower amount of patients experiencing severe pain (25.0 vs. 36.0%) compared to PDT with BF-200-ALA. Conclusion: Our data shows that PDT using MAL is less painful than PDT using BF-200-ALA resulting in a significantly lower mean VAS score (p < 0.001), significantly fewer patients experiencing severe pain (p < 0.001) and a significantly (p < 0.05) lower number of treatment interruptions. Differences in selectivity for tumour cells and transport of ALA in peripheral neurons may play a role.

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Variable pulsed light is less painful than light-emitting diodes for topical photodynamic therapy of actinic keratosis: a prospective randomized controlled trial

Abstract: VPL used for MAL-PDT is an efficient alternative for the treatment of AK that results in complete remission and cosmesis equivalent to LED irradiation but causes significantly less pain.

Cited by 98 publications

References 41 publications

Current evidence and applications of photodynamic therapy in dermatology

Current evidence and applications of photodynamic therapy in dermatology

Pain associated with aminolevulinic acid-photodynamic therapy of skin disease

Treatment with 5-Aminolaevulinic Acid Methylester Is Less Painful than Treatment with 5-Aminolaevulinic Acid Nanoemulsion in Topical Photodynamic Therapy for Actinic Keratosis

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