Filbeck T, Wimmershoff M B, Pichlmeier U, Karrer S, Wieland W F, Szeimies R M, Rössler W
Department of Urology, St. Joseph's Hospital, University of Regensburg, Germany.
Urol Int. 2000;64(3):126-8. doi: 10.1159/000030511.
A prospective monocenter open study was carried out to evaluate if generalized phototoxic skin reactions occur after intravesical application of 5-aminolevulinic acid (ALA) for fluorescence diagnosis of superficial bladder carcinomas.
On 21 patients, skin phototoxicity was determined prior to as well as 4, 8 and 28 h after intravesical instillation of a 3% ALA solution by exposing small skin areas to a progressively graded series of defined UVA-light doses (n = 9; 5-80 J/cm(2)).
Prior to ALA instillation, erythema or pigmentation as signs of cutaneous phototoxicity occurred at an UVA-light dose of 28 +/- 1.5 J/cm(2) (mean +/- SEM). A reduction of the minimal phototoxic dose (MPD) was not detected 4 (28 +/- 1.9 J/cm(2)), 8 (28 +/- 1.6 J/cm(2)) and 28 h (28 +/- 1.5 J/cm(2)) after ALA instillation. Consequently phototoxic reactions were not observed.
A reduction of MPD for UVA was not detected. Therefore, it is not necessary to protect the skin of patients from ambient or daylight after intravesical instillation of ALA for fluorescence diagnosis.
开展了一项前瞻性单中心开放性研究，以评估膀胱内应用5-氨基酮戊酸（ALA）用于浅表性膀胱癌荧光诊断后是否会发生全身性光毒性皮肤反应。
对21例患者，在膀胱内灌注3% ALA溶液之前以及之后4、8和28小时，通过将小面积皮肤暴露于一系列逐渐递增的特定UVA光剂量（n = 9；5 - 80 J/cm²）来测定皮肤光毒性。
在灌注ALA之前，在UVA光剂量为28 ± 1.5 J/cm²（平均值 ± 标准误）时出现红斑或色素沉着作为皮肤光毒性的体征。在灌注ALA后4小时（28 ± 1.9 J/cm²）、8小时（28 ± 1.6 J/cm²）和28小时（28 ± 1.5 J/cm²）未检测到最小光毒性剂量（MPD）的降低。因此未观察到光毒性反应。
未检测到UVA的MPD降低。因此，膀胱内灌注ALA用于荧光诊断后，无需保护患者皮肤免受环境光或日光照射。
