Acne‐photodynamic therapy with intra‐lesional injection of 5‐aminolevulinic acid

Abstract

Photodynamic therapy (PDT) is a treatment option for acne patients who fail to respond to conventional therapy. Although potent, we experience side effects such as erythema, exfoliation and dyspigmentation. In attempt to specify treatment and shorten the incubation time, we injected 5-aminolevulinic acid (ALA) to the individual lesion. The results of intralesional injection ILI-PDT and conventional PDT are compared in this study.

Current evidence and applications of photodynamic therapy in dermatology

“…Other topical photosensitizers, which have been studied less extensively, include indocyanine green (or methylene blue) and indole-3-acetic acid 32,33,108–113. Indole-3-acetic acid in particular may have an important role in clinical practice, primarily because patients receiving indole-3-acetic acid for acne experience less pain.…”

Current Evidence and Applications of Photodynamic Therapy in Dermatology

“…32,33,[108][109][110][111][112][113] Indole-3-acetic acid in particular may have an important role in clinical practice, primarily because patients receiving indole-3-acetic acid for acne experience less pain. It also has promising practical aspects, requiring shorter incubation times whilst producing equivalent efficacy (Table 2).…”

Intralesional Photodynamic Therapy: A Comment on ‘Pretreatment to Enhance Protoporphyrin IX Accumulation in Photodynamic Therapy’ by Gerritsen et al.

“…Moreover, a study showed that the fluorescence induced by the intralesional injection of the prodrug was present as early as 4 h [9] ; nonetheless, the time necessary to allow the conversion of the prodrug into the final photosensitizer is likely to be much shorter, as incubations ! 1 h were shown to be effective as well [2,8] . It has also been proposed that intralesional PDT may be particularly effective in inflammatory disorders in which the epidermal surface is intact or nearly intact and the dermis thickened for physiological (scalp) or pathological reasons (morphea) [10] .…”

“…In black patients, intralesional PDT may overcome, if not the diminished penetration of light due to the increased melanin filter, at least the increased thickness of the stratum corneum [11] . Also according to our experience, this technique does not affect the compliance of patients [6] and causes fewer side effects (erythema, crusting) in the postirradiation period than conventional topical PDT [8] .…”

“…The authors did not mention intralesional PDT, a seldom used technique which potential, though, is in our opinion underrecognized and underestimated.As shown in table 1 , intralesional PDT has been reported to be an effective and safe treatment for skin metastases of breast cancer [2] , superficial and nodular basal-cell carcinoma [3,4,6,7] , squamous-cell carcinoma [4][5][6][7] , Paget's disease [5] and acne vulgaris [8] . We have also successfully treated anogenital condylomata [unpubl.…”