Melanie D Palm1, Mitchel P Goldman. 1. Dermatology/Cosmetic Laser Associates of La Jolla, Inc., San Diego, CA Surfside Advanced Aesthetic Dermatology, Encinitas, CA 92121, USA. melanie.palm@gmail.com
Abstract
BACKGROUND AND OBJECTIVE:methyl aminolevulinate (MAL) is a recently FDA-approved molecule for photodynamic therapy (PDT) in the treatment of nonhyperkeratotic actinic keratoses (AK). In the U.S., aminolevulinic acid (ALA) has been used in an off-label manner with photodynamic therapy for the treatment of chronic photodamage. The published use of MAL-PDT for photorejuvenation is more limited. MAL-PDT is usually conducted with a red light source, ALA-PDT with a blue light source. The purpose of this study is to compare the use of red versus blue light sources in the treatment of photodamage using MAL-PDT, measuring safety and efficacy outcomes following treatment. STUDY DESIGN/ MATERIAL AND METHODS:eighteen adult patients with moderate-to-severe photodamage of the head or upper trunk were enrolled in a prospective, single center trial of MAL-PDT for photorejuvenation. Intrapatient randomization determined split-area treatment with a blue or red light source. The majority of patients were also treated with pulsed dye laser (PDL) and/or intense pulsed light (IPL) for photoactivation. Digitial photography documented the treatment area at each visit (days 0, 2, 7 and 30). Patient and physician scoring of photodamage occurred at baseline and final visits. Side effects following MAL-PDT were evaluated. RESULTS: no statistically significant differences in signs of photodamage following MAL-PDT were observed between blue versus red light treated sides. The greatest improvement in photodamage measures following 1 MAL-PDT were pigmentation, AK and erythema. Side effects were mild in nature and did not differ between treatment sides, and all but mild erythema resolved by day 7. CONCLUSION:blue and red light have similar efficacy as the light source for MAL-PDT when combined with other light sources. Side effects following MAL-PDT with red versus blue light were similar and mild in severity. MAL-PDT is an effective treatment modality for chronic photodamage, in particular AK and pigmentation.
RCT Entities:
BACKGROUND AND OBJECTIVE:methyl aminolevulinate (MAL) is a recently FDA-approved molecule for photodynamic therapy (PDT) in the treatment of nonhyperkeratotic actinic keratoses (AK). In the U.S., aminolevulinic acid (ALA) has been used in an off-label manner with photodynamic therapy for the treatment of chronic photodamage. The published use of MAL-PDT for photorejuvenation is more limited. MAL-PDT is usually conducted with a red light source, ALA-PDT with a blue light source. The purpose of this study is to compare the use of red versus blue light sources in the treatment of photodamage using MAL-PDT, measuring safety and efficacy outcomes following treatment. STUDY DESIGN/ MATERIAL AND METHODS: eighteen adult patients with moderate-to-severe photodamage of the head or upper trunk were enrolled in a prospective, single center trial of MAL-PDT for photorejuvenation. Intrapatient randomization determined split-area treatment with a blue or red light source. The majority of patients were also treated with pulsed dye laser (PDL) and/or intense pulsed light (IPL) for photoactivation. Digitial photography documented the treatment area at each visit (days 0, 2, 7 and 30). Patient and physician scoring of photodamage occurred at baseline and final visits. Side effects following MAL-PDT were evaluated. RESULTS: no statistically significant differences in signs of photodamage following MAL-PDT were observed between blue versus red light treated sides. The greatest improvement in photodamage measures following 1 MAL-PDT were pigmentation, AK and erythema. Side effects were mild in nature and did not differ between treatment sides, and all but mild erythema resolved by day 7. CONCLUSION: blue and red light have similar efficacy as the light source for MAL-PDT when combined with other light sources. Side effects following MAL-PDT with red versus blue light were similar and mild in severity. MAL-PDT is an effective treatment modality for chronic photodamage, in particular AK and pigmentation.
Authors: Ana Luiza Ribeiro de Souza; Kayla Marra; Jason Gunn; Kimberley S Samkoe; Stephen Chad Kanick; Scott C Davis; M Shane Chapman; Edward V Maytin; Tayyaba Hasan; Brian W Pogue Journal: Br J Cancer Date: 2016-08-30 Impact factor: 7.640