Department of Dermatology, The Seventh People's Hospital of Shenyang, Shenyang, China.
Department of Cardiology, The Seventh People's Hospital of Shenyang, Shenyang, China.
Lasers Surg Med. 2022 Feb;54(2):224-229. doi: 10.1002/lsm.23464. Epub 2021 Aug 8.
A two-step irradiance schedule has been found to be useful for pain control during photodynamic therapy (PDT) on nonmelanotic skin cancer and condyloma acuminatum.
To evaluate the efficacy of a new three-step irradiance schedule derived from the psychological "peak-end rule" and two-step irradiance schedule in relieving pain during 5-aminolevulinic acid PDT (ALA-PDT) on acne.
A total of 90 moderate to severe acne patients were enrolled in our study and randomly divided into two groups with a ratio of 1:1. They were treated by a light-emitting diode light source of 633 ± 10 nm after being incubated with 5% ALA for an hour using a two-step or three-step irradiance schedule, respectively. The total irradiance intensity was 84 J/cm of each session and the treatment interval was 2 weeks. Pain was recorded 30 min after each PDT using a visual analog scale (VAS). Follow-up was done at baseline and 2 weeks after each treatment. The numbers of lesions were counted after the third treatment through the pictures taken before and all the side effects were recorded at each follow-up visit.
Eighty-seven subjects completed the total three treatments (44 cases in Group A and 43 cases in Group B). The average VAS of Group B (1.61 ± 0.67) was significantly lower than that of Group A (3.14 ± 0.67), with a difference of 1.52 ± 0.08 (p < 0.0001) between them. Both groups received a similar effective rate after the total three sessions (88.64% vs. 88.37%, p > 0.05).
The new three-step irradiance method could relieve pain during ALA-PDT more significantly than the two-step schedule with a similar effective rate.
两步辐照度方案已被证明在非黑素性皮肤癌和尖锐湿疣的光动力疗法（PDT）期间控制疼痛是有效的。
评估源自心理“峰终法则”的新三步辐照度方案和两步辐照度方案在缓解 5-氨基酮戊酸 PDT（ALA-PDT）治疗痤疮疼痛方面的疗效。
共纳入 90 例中重度痤疮患者，随机分为两组，比例为 1:1。两组患者分别采用两步和三步辐照度方案，用 633±10nm 的发光二极管光源治疗，分别用 5%ALA 孵育 1 小时。每个疗程的总辐照度强度为 84J/cm，治疗间隔为 2 周。每次 PDT 后 30min 使用视觉模拟评分（VAS）记录疼痛。在基线和每次治疗后 2 周进行随访。第三次治疗后通过拍照计数皮损数，并在每次随访时记录所有不良反应。
87 例患者完成了全部三次治疗（A 组 44 例，B 组 43 例）。B 组的平均 VAS（1.61±0.67）明显低于 A 组（3.14±0.67），两者相差 1.52±0.08（p<0.0001）。两组在三次疗程结束后均具有相似的有效率（88.64% vs. 88.37%，p>0.05）。
新的三步辐照度方案在缓解 ALA-PDT 疼痛方面比两步方案更有效，且具有相似的有效率。
