Shanghai Skin Diseases Hospital, Shanghai, People's Republic of China.
J Cutan Med Surg. 2012 Sep-Oct;16(5):324-33. doi: 10.1177/120347541201600509.
Topical photodynamic therapy (PDT) mediated with 5-aminolevulinic acid (ALA) offers an alternative option for the treatment of acne vulgaris.
To study the effects of ALA dose, incubation time, and lesion type on protoporphyrin IX (PpIX) production and treatment outcomes.
To examine the time course of PpIX production, 10% ALA was applied to inflammatory papules for 1 to 5 hours and followed by in situ fluorescence examination. To determine the effects of ALA dose and lesion type, 3, 5, and 10% ALA was applied to acne lesions in split-face fashion for 3 hours followed by whole-face light irradiation at 633 nm and 30 to 70 J/cm2. Treatment was repeated twice at 2-week intervals.
PpIX reached a stable level after 3 hours of incubation. Similar PpIX levels were seen in areas receiving 3, 5, and 10% ALA. Poisson regression analyses indicated that lesion counts decreased by 0.791 times for a one-unit increase in treatment times (95% CI 0.782-0.799 < .0001) but only by 0.999 times for a one-unit increase in ALA dose (95% CI 0.998-1.000 = .22).
The combination of low-dose ALA and a red light is a safe and effective option for the treatment of moderate to severe acne.
5-氨基酮戊酸（ALA）介导的局部光动力疗法（PDT）为治疗寻常痤疮提供了另一种选择。
研究 ALA 剂量、孵育时间和病变类型对原卟啉 IX（PpIX）生成和治疗效果的影响。
为了研究 PpIX 生成的时间过程，将 10%的 ALA 应用于炎性丘疹 1 至 5 小时，然后进行原位荧光检查。为了确定 ALA 剂量和病变类型的影响，以分割面部的方式将 3%、5%和 10%的 ALA 应用于痤疮病变 3 小时，然后用 633nm 的全脸光照射 30 至 70J/cm2。间隔 2 周重复治疗 2 次。
孵育 3 小时后 PpIX 达到稳定水平。在接受 3%、5%和 10%ALA 的区域中观察到相似的 PpIX 水平。泊松回归分析表明，治疗次数增加一个单位，病变计数减少 0.791 倍（95%CI 0.782-0.799，<.0001），但 ALA 剂量增加一个单位，病变计数仅减少 0.999 倍（95%CI 0.998-1.000，=0.22）。
低剂量 ALA 与红光联合是治疗中重度痤疮的安全有效选择。
