Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study

Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study

Background: Actinic keratoses (AKs) are the most common premalignant tumors. Without treatment, a significant number of patients with AK will experience squamous cell carcinoma. Photodynamic therapy (PDT) using the new highly selective photosensitizer methyl 5-aminolevulinate is a promising new trea...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology Vol. 47; no. 2; pp. 258 - 262
Main Authors: Szeimiesa, R.M., Karrera, S., Radakovic-Fijanb, S., Tanewb, A., Calzavara-Pintonc, P.G., Zanec, C., Sidoroffd, A., Hempele, M., Ulrichf, J., Proebstleg, T., Mefferth, H., Mulderi, M., Salomonj, D., Dittmark, H.C., Bauerl, J.W., Kernlandm, K., Braathenm, L.
Format: Journal Article
Language:English
Published: New York, NY Mosby, Inc 01-08-2002
Elsevier
Subjects:
Administration, Topical
Adult
Aged
Aged, 80 and over
Aminolevulinic Acid - administration & dosage
Aminolevulinic Acid - analogs & derivatives
Aminolevulinic Acid - therapeutic use
Biological and medical sciences
Cryotherapy
Dermatology
Dyskeratosis
Female
Humans
Keratosis - drug therapy
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Photochemotherapy
Photosensitizing Agents - administration & dosage
Photosensitizing Agents - therapeutic use
Prospective Studies
Skin, nail, hair, dermoskeleton
Treatment Outcome
Human
Dyskeratosis
Photosensitivity
Skin disease
Premalignant lesion
Photodynamic therapy
Hyperkeratosis
Genetic disease
Prospective
Photodermatosis
Chemotherapy
Randomization
Treatment
Actinic porokeratosis
Actinic lichenoid keratosis
Methyl 5-aminolevulinate
Topical administration
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Summary:Background: Actinic keratoses (AKs) are the most common premalignant tumors. Without treatment, a significant number of patients with AK will experience squamous cell carcinoma. Photodynamic therapy (PDT) using the new highly selective photosensitizer methyl 5-aminolevulinate is a promising new treatment modality for AK. Objective: We investigated the complete response rates, cosmetic outcome, and patient satisfaction after photodynamic therapy (PDT) using methyl 5-aminolevulinate (Metvix) versus cryotherapy in the treatment of AKs. Methods: Patients were randomized to receive either cryotherapy with liquid nitrogen spray or PDT using methyl 5-aminolevulinate cream 160 mg/g, 3 hours application time, and red light (75 J/cm2). Results: Efficacy results from 193 patients with 699 lesions (92% face/scalp and 93% thin/moderately thick) were analyzed. Overall complete response rates after 3 months were 69% for PDT and 75% for cryotherapy. Both treatments gave higher response rates in thin lesions (PDT 75%, cryotherapy 80%). PDT gave better cosmetic results and higher patient satisfaction than cryotherapy. Conclusion: PDT using methyl 5-aminolevulinate is an attractive treatment option for patients with AK, with a response rate similar to that of cryotherapy, but with superior cosmetic results and high patient satisfaction. (J Am Acad Dermatol 2002;47:258-62.)
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0190-9622
1097-6787
DOI:10.1067/mjd.2002.119649