Department of Dermatology, Tor Vergata University, Rome, Italy.
Unit of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
G Ital Dermatol Venereol. 2020 Oct;155(5):636-641. doi: 10.23736/S0392-0488.20.06598-0. Epub 2020 Oct 7.
Photodynamic therapy (PDT) is recommended for both lesion and field therapy of actinic keratoses (AKs). The 5-aminolaevulinic acid (5-ALA) patch PDT is indicated for the treatment of isolated mild AKs (≤1.8 cm) on the face and bald scalp. It was demonstrated to be effective and safe in clinical trials with a good tolerability profile.
In this retrospective multicenter real-life study, 33 patients with a total of 99 AKs of the scalp, face, ears, and/or hands and 2 actinic cheilitis were treated with one treatment session of 5-ALA patch PDT with a red light source (total dose of 37 J/cm).
Overall, 12 weeks after treatment, 68/99 (69%) lesions were completely cleared. Complete response was obtained in 82% of AKs on the ears, 78% on the face, 57% on the hands, and 56% on the scalp and in the two actinic cheilitis. The treatment was very effective on grade I AKs, cleared in 87% of the cases and less efficient on grade II-III lesions, cleared in 47% of the cases. 5-ALA patch PDT was well tolerated with a good to excellent cosmetic outcome in 97% of the patients and with 94% of the patients being satisfied or very satisfied with the treatment.
Our results confirm that 5-ALA patch PDT is a good option for AK treatment in clinical practice, it is easy to use, effective and well tolerated even in difficult-to-treat-areas. Moreover, it has an excellent cosmetic outcome.
光动力疗法(PDT)被推荐用于治疗光化性角化病(AK)的病变和野区治疗。5-氨基酮戊酸(5-ALA)贴剂 PDT 适用于治疗面部和光头头皮上孤立的轻度 AK(≤1.8cm)。临床试验证明其具有有效性和安全性,且具有良好的耐受性。
在这项回顾性多中心真实世界研究中,33 名患者共 99 处头皮、面部、耳朵和/或手部 AK 和 2 例光化性唇炎接受了一次 5-ALA 贴剂 PDT 治疗,使用红光源(总剂量为 37J/cm)。
总体而言,治疗后 12 周,68/99(69%)病灶完全清除。耳部 AK 的完全缓解率为 82%,面部为 78%,手部为 57%,头皮和光化性唇炎为 56%。该治疗对 I 级 AK 非常有效,87%的病例完全清除,对 II-III 级病变的疗效较差,仅 47%的病例完全清除。97%的患者对 5-ALA 贴剂 PDT 耐受性良好,美容效果良好至极好,94%的患者对治疗满意或非常满意。
我们的结果证实,5-ALA 贴剂 PDT 是临床实践中治疗 AK 的一种较好选择,它易于使用,有效且耐受性良好,即使在治疗困难的区域也是如此。此外,它具有极好的美容效果。