Thursday, March 27, 2008

Daylight PDT for actinic keratoses

Continuous activation of PpIX by daylight is as effective as and less painful than conventional photodynamic therapy for actinic keratoses; a randomized, controlled, single-blinded study
Authors: Wiegell, S.R.; Hædersdal, M.; Philipsen, P.A.; Eriksen, P.1; Enk, C.D.2; Wulf, H.C.
Source: British Journal of Dermatology, Volume 158, Number 4, April 2008 , pp. 740-746(7)
Publisher: Blackwell Publishing
Abstract:
Summary Background
Photodynamic therapy (PDT) is a highly effective treatment for actinic keratoses (AK); however, it is time consuming and often painful for the patient. Daylight-PDT would make the treatment independent of the clinic and less painful due to the continuous activation of small amounts of porphyrins during its formation. Objectives
The objective of this randomized controlled study was to compare response rates and adverse effects after methyl aminolevulinate (MAL)-PDT using conventional red light-emitting diode (LED) light vs. daylight. Patients/methods
Twenty-nine patients with AK of the face and scalp were treated with MAL-PDT in two symmetrical areas. One area was illuminated by red LED light (37 J cm−2) after 3-h incubation with MAL under occlusive dressing. The other area was treated with daylight for 2·5 h after the MAL cream had been under occlusion for half an hour. Results
We found no significant difference in the treatment effect between the two treatments (P = 0·13), with a reduction of AK lesions of 79% in the daylight area compared with 71% in the LED area. Treatment response in the daylight area did not depend on the intensity of the daylight. Illumination with LED was more painful than daylight (P < 0·0001). Erythema and crusting occurred after both treatments and were similar in the two areas. Conclusions
PDT of AK by continuous activation of porphyrins by daylight proved to be as effective as conventional PDT. PDT using daylight activation will make the treatment of these extremely common premalignant tumours more time and cost effective, and more convenient for the patient.

2 comments:

Anonymous said...

This was the prize winning presentation at Euro PDT 2008 in Barcelona. With average Perth summer midday exposure for adeqaute Vit D being 2-4 minutes, this may not be arecommended other than ayt dawn or dusk . Young swedish blondes have it all !

Anonymous said...

PS no mention of latitude, date in relation to summer solstice, cloud cover or UV index.