Wiegell Stine R, Lerche Catharina M, Wulf Hans Christian
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Photodermatol Photoimmunol Photomed. 2016 Mar;32(2):88-92. doi: 10.1111/phpp.12227. Epub 2015 Dec 15.
If the recommended 1.0 mm layer of methyl aminolevulinate (MAL) is used during photodynamic therapy (PDT) of large areas with multiple actinic keratoses (AK) huge amounts of cream are needed.
To report the amount of MAL used for PDT of AK and basal cell carcinomas (BCC) in daily routine. The association of protoporphyrin IX (PpIX) fluorescence and thickness of MAL was investigated in a randomized paired study in healthy volunteers.
Amount of cream used per cm(2) during conventional and daylight PDT was recorded. In 16 healthy volunteers, 0.1 mm, 0.2 mm, 0.5 mm and 1.0 mm MAL cream were applied for 3 h on tape-stripped areas on each forearm randomized to light-permeable or light-impermeable occlusion. PpIX fluorescence was measured.
Less than 0.4 mm MAL was used during PDT of BCC and 0.2 mm for AK. No difference in PpIX fluorescence was found between the different thicknesses of MAL using light-impermeable occlusion.
In daily routine <0.4 mm MAL was used during PDT of BCC and 0.1-0.2 mm MAL during PDT of AK. The recommended 1.0 mm MAL did not result in a higher accumulation of PpIX compared to thinner MAL layers after light-impermeable occlusion for 3 h.
在对大面积多发光化性角化病（AK）进行光动力疗法（PDT）时，如果使用推荐的1.0毫米厚的甲基氨基酮戊酸（MAL）乳膏，需要大量的乳膏。
报告日常工作中用于AK和基底细胞癌（BCC）光动力治疗的MAL用量。在一项针对健康志愿者的随机配对研究中，研究了原卟啉IX（PpIX）荧光与MAL厚度之间的关系。
记录常规光动力治疗和日光光动力治疗期间每平方厘米使用的乳膏量。在16名健康志愿者中，将0.1毫米、0.2毫米、0.5毫米和1.0毫米的MAL乳膏分别涂于每个前臂经胶带剥离的区域，随机采用透光或不透光封闭，持续3小时。测量PpIX荧光。
BCC光动力治疗期间使用的MAL厚度小于0.4毫米，AK光动力治疗期间使用的MAL厚度为0.2毫米。采用不透光封闭时，不同厚度的MAL之间PpIX荧光无差异。
在日常工作中，BCC光动力治疗期间使用的MAL厚度小于0.4毫米，AK光动力治疗期间使用的MAL厚度为0.1 - 0.2毫米。在不透光封闭3小时后，与较薄的MAL层相比，推荐的1.0毫米MAL并未导致更高的PpIX蓄积。
