Conflicts of interest C.B.H., J.P., C.S. and H.G. have no conflict of interest to declare. A.-M.W. has taken part in clinical trials with Galderma, PhotoCure, 3M and Fujisawa. She has received fees for giving lectures from Galderma, PhotoCure, 3M, Fujisawa and Schering-Plough.
Nerve blocks enable adequate pain relief during topical photodynamic therapy of field cancerization on the forehead and scalp
Version of Record online: 4 FEB 2009
© 2009 The Authors. Journal Compilation © 2009 British Association of Dermatologists
British Journal of Dermatology
Volume 160, Issue 4, pages 795–800, April 2009
How to Cite
Halldin, C.B., Paoli, J., Sandberg, C., Gonzalez, H. and Wennberg, A.-M. (2009), Nerve blocks enable adequate pain relief during topical photodynamic therapy of field cancerization on the forehead and scalp. British Journal of Dermatology, 160: 795–800. doi: 10.1111/j.1365-2133.2008.09024.x
- Issue online: 18 MAR 2009
- Version of Record online: 4 FEB 2009
- Accepted for publication 3 November 2008
- actinic keratoses;
- field cancerization;
- nerve block;
- photodynamic therapy
Background Topical photodynamic therapy (PDT) is an effective method when treating extensive areas of sun-damaged skin with multiple actinic keratoses (AKs) (field cancerization) on areas such as the forehead and scalp, and offers excellent cosmetic outcome. The major side-effect of PDT is the pain experienced during treatment.
Objectives To investigate whether nerve blocks could provide adequate pain relief during PDT of AKs on the forehead and scalp.
Methods Ten men with symmetrically distributed and extensive AKs on the forehead and scalp were included in the study. Prior to PDT one side of the forehead and scalp was anaesthetized by nerve blocks while the other side served as control.
Results The mean visual analogue scale (VAS) score on the anaesthetized side was 1 compared with 6·4 on the nonanaesthetized side during PDT. This difference was significant (P < 0·0001), implying that nerve blocks reduce VAS scores during PDT.
Conclusions The results of the study support the use of nerve blocks as pain relief during PDT of field cancerization on the forehead and scalp, although individual considerations must be taken into account to find the most adequate pain-relieving method for each patient.