The Effect of Increasing Fluence on the Treatment of Actinic Keratosis and Photodamage by Photodynamic Therapy with 5-Aminolevulinic Acid and Intense Pulsed Light

Abstract

AK clearance, but not photorejuvenation, appears to improve with increasing fluence at the ALA PDT-IPL levels used in this study without serious adverse effects.

Comparative study for the effect of photodynamic therapy, imiquimod immunotherapy and combination of both therapies on 40 lesions of actinic keratosis in Japanese patients

“…Longer duration than 6 months might have disclosed recurrence in some AK lesions in this study. Adverse events of PDT include pain, mild erythema, slight edema, crusts and pigmentation after a few days . Imiquimod may cause local adverse events, including smart pain, erythema, erosions and crusts, but all are mild in many cases .…”

Intense pulsed light combined with methyl aminolaevulinate for treating actinic keratoses and photoaged skin of the dorsal hands has considerable advantages. However, is it worth the extra expense?

“…Photodynamic therapy (PDT) using IPL for the treatment of actinic keratoses (AKs) of the face has been described before, with increasing fluence of IPL increasing the efficacy of treating facial AKs . Kohl et al ., in this issue of the BJD , present a study using the same combination to treat AKs on the dorsa of the hands.…”

Photodynamic Therapy for Malignant Skin Lesions

“…Several small studies have investigated intense pulsed light (IPL) and pulsed dye lasers (PDL) as possible light sources for PDT in the treatment of AK (Peng et al 1997 ;Haddad et al 2011 ;Alexiades-Armenakas and Geronemus 2003 ). IPL emits a broad spectrum of visible to near-infrared light.…”

“…Infrared irradiation causes hyperthermia, and it has been suggested that mild hyperthermia may act synergistically with PDT (Peng et al 1997 ;. The combination of ALA-PDT with an IPL source has been shown to improve AK clearance compared to IPL alone (Haddad et al 2011 ). Long pulsed PDL (595 nm) in combination with ALA-PDT also has proven effi cacy for eradicating AKs compared to PDL (AlexiadesArmenakas and Geronemus 2003 ).…”