Topical 5-aminolaevulinic acid photodynamic therapy for cutaneous lesions: outcome and comparison of light sources.
BACKGROUND
Topical 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) is increasingly used for superficial non-melanoma skin cancers and their precursors.


METHODS
We report our 3-year experience of topical ALA-PDT, with a preliminary comparison of the effects of broadband and laser light sources.


RESULTS
We performed 688 treatments on 483 lesions in 207 patients. Complete clearance was achieved in 222/239 lesions of Bowen's disease (BD), superficial basal cell carcinoma (sBCC) and actinic keratosis (AK) (93%) - 117/129 BD (91%), 84/87 sBCC (97%) and 21/23 AK (91%), with a median follow up of 48 weeks. Broadband and laser light sources were of similar efficacy. Recurrences have occurred in 10.3% BD, 4.8% sBCC and 4.8% AK. Adverse effects from PDT were uncommon but included pigmentary change (2%) and minor scarring (2%). How-ever, severe pain was experienced in 16-21% of treatments using the high-output broadband and laser sources, but in only 2% with the low-output xenon arc source.


CONCLUSIONS
Topical ALA-PDT is effective for BD, sBCC and AK and has been an invaluable addition to our dermatology service. Efficacy is similar for broadband and laser light sources, although treatment at higher surface irradiance may be painful, and excellent cosmetic results can be achieved.
Clark
C
C
Department of Dermatology, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK.
Bryden
A
A
Dawe
R
R
Moseley
H
H
Ferguson
J
J
Ibbotson
S H
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage*; D001913:Bowen's Disease / Q000188:drug therapy / Q000473:pathology; D002280:Basal Cell Carcinoma / Q000188:drug therapy / Q000473:pathology; D004739:England; D005260:Female; D006801:Humans; D007642:Keratosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology; D010778:Photochemotherapy / Q000295:instrumentation*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid