5-Aminolevulinic acid-mediated photodynamic therapy to superficial malignant skin tumors using Super Lizer

Abstract

Photodynamic therapy (PDT) using topically applied 5-aminolevulinic acid (ALA) has become a generally accepted treatment modality for superficial malignant skin tumors. However, the costly excimer-dye laser, diode laser and light-emitting diode (LED) frequently used to administrate PDT are impractical to use in most dermatology clinics. This study evaluated the effectiveness of ALA-mediated PDT using a Super Lizer (Tokyo Iken, Tokyo, Japan) equipped with band-pass filters in 38 patients with superficial malignant skin tumors (33 cases of actinic keratosis and five cases of Bowen's disease). Twenty-one cases (18 cases of actinic keratosis and three cases of Bowen's disease) were successfully treated, and the other 17 cases (15 cases of actinic keratosis and two cases of Bowen's disease) showed partial remission after single or repeated administration of PDT. PDT repeated three times at weekly intervals was more effective against actinic keratosis than randomly repeated procedures. The Super Lizer is easy to handle and move, and is less expensive than other known machinery and is useful for PDT in dermatology, especially under the protocol of three times at weekly intervals for the treatment of actinic keratosis.

Comparative Study of Photodynamic Therapy with Topical Methyl Aminolevulinate versus 5-Aminolevulinic Acid for Facial Actinic Keratosis with Long-Term Follow-Up

“…Previous studies showed that the efficacy of ALA-PDT in Asian patients was similar to that in Caucasian patients18,19,20,23. However, higher light doses, longer irradiation times, and several treatment sessions were required because melanin absorbs the light intended for protoporphyrin IX (PpIX) in dark skin types18,19,20,23. Because there are differences in the long-term efficacy and safety of PDT between Asian and Caucasian populations, data obtained from Caucasians cannot necessarily be applied to the Asian population.…”

“…Previous studies on MAL-PDT have shown complete response rates of 69% to 92% for AKs on the face and scalp of Caucasian populations10,14,15,16,17. To date, there have been insufficient studies on dark-skinned ethnic groups that have demonstrated the efficacy of ALA-PDT for AKs18,19,20,23. Nakano et al18 showed that ALA-PDT is useful for the treatment of AKs in Asians, and its efficacy might depend on the lesion size and histopathological severity.…”

“…Nakano et al18 showed that ALA-PDT is useful for the treatment of AKs in Asians, and its efficacy might depend on the lesion size and histopathological severity. However, several treatment sessions (3~6) are needed to achieve a similar efficacy as in Caucasians, and 2 other studies on ALA-PDT reported that its efficacy was 73% to 82%19,23. According to a study performed in Korea, ALA-PDT for AKs on the face and scalp showed a complete response rate of 67% after a single session of ALA-PDT20.…”

“…However, there are insufficient data about the efficacy of either PDT modality for multiple AKs in dark-skinned ethnic groups18,19,20,21,22,23. Furthermore, few studies have evaluated the efficacy of ALA-PDT with a long-term follow-up period in Asian populations23. Previous studies showed that the efficacy of ALA-PDT in Asian patients was similar to that in Caucasian patients18,19,20,23.…”

“…Furthermore, few studies have evaluated the efficacy of ALA-PDT with a long-term follow-up period in Asian populations23. Previous studies showed that the efficacy of ALA-PDT in Asian patients was similar to that in Caucasian patients18,19,20,23. However, higher light doses, longer irradiation times, and several treatment sessions were required because melanin absorbs the light intended for protoporphyrin IX (PpIX) in dark skin types18,19,20,23.…”