序贯使用光动力疗法和5%咪喹莫特乳膏治疗光化性角化病。
Treatment of actinic keratoses with sequential use of photodynamic therapy; and imiquimod 5% cream.
作者信息
Shaffelburg Michael
机构信息
Valley Professional Center, Kentville, Nova Scotia, Canada.
出版信息
J Drugs Dermatol. 2009 Jan;8(1):35-9.
BACKGROUND
Field-directed therapies for actinic keratosis include photodynamic therapy and imiquimod.
OBJECTIVES
The author designed a randomized, vehicle-controlled, split-face study to explore the safety and efficacy of photodynamic therapy followed by imiquimod.
METHODS
The entire face of adults with > or =10 facial actinic keratoses were treated with photodynamic therapy with aminolevulinic acid 20% at baseline and at month 1. At month 2, imiquimod 5% cream was applied to one-half of the face and vehicle to the other half, 2-times-per-week for 16 weeks. Lesion counts were performed at baseline and months 1, 2, 3, 4, 6, and 12; and local skin reactions assessments at months 2, 3, 4, and 6.
RESULTS
Of 25 participants enrolled, 24 completed the study. Baseline median lesions were 23.5 and 21.5 for the imiquimod- and vehicle-treated sides, respectively. At month 12, median lesion reductions was 89.9% versus 74.5% (P=.0023), respectively. No subject discontinued for an adverse event. Severe local skin reactions occurring in the most participants were erythema (17%) and flaking/scaling/dryness (13%).
CONCLUSIONS
Photodynamic therapy followed by imiquimod was well tolerated and improved reduction of actinic keratoses.
背景
光化性角化病的局部定向治疗包括光动力疗法和咪喹莫特。
目的
作者设计了一项随机、赋形剂对照的半脸研究，以探讨光动力疗法联合咪喹莫特的安全性和有效性。
方法
对患有≥10处面部光化性角化病的成年人，在基线和第1个月时用20%氨基乙酰丙酸进行光动力疗法治疗整个面部。在第2个月时，将5%咪喹莫特乳膏涂于半侧面部，另一半面部涂赋形剂，每周2次，共16周。在基线以及第1、2、3、4、6和12个月时进行皮损计数；在第2、3、4和6个月时评估局部皮肤反应。
结果
25名受试者入组，24名完成研究。咪喹莫特治疗侧和赋形剂治疗侧的基线皮损中位数分别为23.5和21.5。在第12个月时，皮损减少中位数分别为89.9%和74.5%（P = .0023）。没有受试者因不良事件而退出。大多数受试者出现的严重局部皮肤反应为红斑（17%）和脱屑/鳞屑/干燥（13%）。
结论
光动力疗法联合咪喹莫特耐受性良好，可改善光化性角化病的减少情况。
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