Present addreses: Im Holenacker 16, CH-3063 Ittigen, Switzerland; bDermpathopathologie Friedrichshafen, Bodensee, Siemensstrasse 6/1 D-88048, Friedrichshafen, Germany; cDermatology & Allergology, Bankstr. 6, 40476 Düsseldorf, Germany; dGemeinschaftspraxis Dr Gardlo und Jovic-Paris, Hauptstr. 108, 53474 Bad Neuenahr, Germany; eBergen Hudlegeklinikk, Valkendorfsgt. 9, 5012 Bergen, Norway; fVolvat Medisinske Senter AB, Fanavegen 98, 5239 Bergen, Norway; gAleris Medisinske senter, Fredrik Stangsgt. 11-13, 0264 Oslo
Short incubation with methyl aminolevulinate for photodynamic therapy of actinic keratoses
Article first published online: 5 JAN 2009
© 2008 The Authors. Journal compilation © 2008 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 23, Issue 5, pages 550–555, May 2009
How to Cite
Braathen, L., Paredes, B., Saksela, O., Fritsch, C., Gardlo, K., Morken, T., Frølich, K., Warloe, T., Solér, A. and Ros, A.-M. (2009), Short incubation with methyl aminolevulinate for photodynamic therapy of actinic keratoses. Journal of the European Academy of Dermatology and Venereology, 23: 550–555. doi: 10.1111/j.1468-3083.2008.03029.x
- Issue published online: 3 APR 2009
- Article first published online: 5 JAN 2009
- Received: 24 June 2008; Accepted 1 October 2008
- actinic keratoses;
- methyl aminolevulinate;
- photodynamic therapy;
- short incubation
Background Photodynamic therapy (PDT) using methyl aminolevulinate (MAL) is an effective first-line treatment for actinic keratoses. A reduced incubation period may have practical advantages.
Objective This study aims to evaluate the effect of incubation time (1 vs. 3 h), MAL concentration (160 mg/g vs. 80 mg/g) and lesion preparation in the setting of MAL-PDT for treatment of actinic keratosis (AK).
Design Open, randomized, parallel-group multicentre study.
Setting Outpatient dermatology clinics.
Subjects One hundred and twelve patients with 384 previously untreated AK. Most lesions (87%) were located on the face and scalp and were thin (55%) or moderately thick (34%).
Methods Lesions were debrided, and MAL cream (160 mg/g or 80 mg/g) was applied before illumination with red light (570–670 nm; light dose, 75 J/cm2). Patients were followed up at 2 and 3 months. Sixty patients (54%) were re-treated and assessed at 6 months.
Main outcome Complete lesion response rates 3 and 12 months after last treatment.
Results For lesions on the face/scalp, lesion complete response rates were 78% for thin AK and 74% for moderately thick AK lesions after 1 h vs. 96% and 87% after 3 h incubation with MAL 160 mg/g. Lesion recurrence rates at 12 months after two treatments were similar [19% (3 of 16) with 1 h vs. 17% (3 of 18) with 3 h 160 mg/kg MAL-PDT] and lower than for 80 mg/g MAL-PDT (44–45%).
Conclusion MAL-PDT using a 1-h incubation may be sufficient for successful treatment of selected AK lesions.
Conflicts of interest
Lasse R Braathen consults for Photocure and has received speaker honoraria from Photocure and Galderma. Trond Warloe is a co-inventor of the corresponding patent and is a minor share holder of Photocure ASA. Tore Morken has been paid as a chairman of a Photocure-sponsored symposium. Bruno E Paredes, Olli Saksela, Clemens Fritsch, Kerstin Gardlo, Karin W Frölich, Ana M Solér and Ann-Marie Ros do not have any relevant conflict of interest, financial or otherwise.