Jeffes E W, McCullough J L, Weinstein G D, Fergin P E, Nelson J S, Shull T F, Simpson K R, Bukaty L M, Hoffman W L, Fong N L
Department of Dermatology, University of California, Irvine, USA.
Arch Dermatol. 1997 Jun;133(6):727-32.
To examine the safety and efficacy of photodynamic therapy using topical 5-aminolevulinic acid (ALA) and red light to treat actinic keratoses (AKs).
Actinic keratoses were treated with topical ALA (concentrations of 0%, 10%, 20%, or 30%) under occlusion for 3 hours. Before photodynamic therapy, sites were examined for fluorescence. Sites were irradiated with an argon pumped dye laser (630 nm) at fluences of 10 to 150 J/cm2.
Academic medical center.
Forty patients with 6 clinically typical, previously untreated AKs per patient.
Complete resolution and decrease in lesion area of the AK relative to baseline evaluated at weeks 1, 4, 8, and 16.
Three hours after ALA administration, lesions showed moderate red fluorescence. Cutaneous phototoxic effects, localized erythema and edema, peaked at 72 hours. Patients experienced mild burning and stinging during light exposure. Eight weeks after a single treatment using 30% ALA, there was total clearing of 91% of lesions on the face and scalp and 45% of lesions, on the trunk and extremities. No significant differences were observed in clinical responses with treatment using 10%, 20%, or 30% ALA. All concentrations of ALA were more effective than treating AKs with vehicle and light.
Topical photodynamic therapy with ALA is an effective treatment of typical AKs. Complete clearing of nonhypertrophic AKs can be achieved with 10%, 20%, or 30% ALA that is easily tolerated by the patient. Lesions on the face and scalp are more effectively treated than lesions on the trunk and extremities. Hypertrophic AKs did not respond effectively.
探讨外用5-氨基酮戊酸（ALA）联合红光光动力疗法治疗光化性角化病（AKs）的安全性和有效性。
采用外用ALA（浓度分别为0%、10%、20%或30%）封包3小时治疗光化性角化病。光动力治疗前，检查皮损部位的荧光情况。使用氩离子泵浦染料激光（630nm）以10至150J/cm²的能量密度照射皮损部位。
学术医疗中心。
40例患者，每位患者有6个临床典型、未经治疗的AK皮损。
在第1、4、8和16周评估AK皮损相对于基线的完全消退情况和皮损面积减小情况。
ALA给药3小时后，皮损呈现中度红色荧光。皮肤光毒性反应，即局部红斑和水肿，在72小时达到峰值。患者在光照期间有轻度灼痛和刺痛感。单次使用30%ALA治疗8周后，面部和头皮上91%的皮损完全清除，躯干和四肢上45%的皮损完全清除。使用10%、20%或30%ALA治疗的临床反应未见显著差异。所有浓度的ALA均比单纯使用赋形剂和光照治疗AK更有效。
外用ALA光动力疗法是治疗典型AK的有效方法。10%、20%或30%的ALA可有效清除非肥厚性AK，患者耐受性良好。面部和头皮上的皮损比躯干和四肢上的皮损治疗效果更好。肥厚性AK治疗效果不佳。
