title: Treatment of actinic cheilitis using photodynamic therapy with methyl aminolevulinate: report of three cases.
abstract: BACKGROUND
  Patients with actinic cheilitis should be treated to prevent transformation into invasive squamous cell carcinoma. Treatment options comprise, for instance, destructive approaches, such as vermilionectomy and carbon dioxide laser ablation. Photodynamic therapy (PDT) has demonstrated high efficacy in patients with epithelial skin cancers, but there is only one report on PDT with free delta-aminolevulinic acid (ALA) and noncoherent light in the treatment of actinic cheilitis.
  
  
  OBJECTIVE
  We report the treatment of three patients with actinic cheilitis with PDT using the new photosensitizing agent methyl aminolevulinate (methyl-5-amino-4-oxopenthanoate [MAOP]) combined with red light.
  
  
  METHODS
  MAOP was topically applied on the lower lip 3 hours before treatment with red light. Two consecutive treatments, 1 week apart, were administered. Clinical assessment was performed up to 13 months after the initial treatment.
  
  
  RESULTS
  A good clinical response with an excellent cosmetic outcome was observed in all three patients. Moderate to severe pain was associated with the application of the red light, and mild inflammation with edema of the lower lip occurred.
  
  
  CONCLUSIONS
  This is the first use of PDT with MAOP and 634 mm wavelength red light in patients with actinic cheilitis. The clinical results demonstrate that PDT might be an alternative for patients who refuse surgical procedures. However, further studies are needed to compare the efficacy and cosmetic outcome with conventional treatment modalities.
authors.affiliation: Department of Dermatology, University Hospital Schleswig-Holstein, Schittenhelmstrasse 7, 24105 Kiel, Germany. ahauschild@dermatology.uni-kiel.de
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
authors.forename: Stephan
authors.initials: S
authors.lastname: Lischner
authors.forename: Bernhard
authors.initials: B
authors.lastname: Lange-Asschenfeldt
authors.forename: Friederike
authors.initials: F
authors.lastname: Egberts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D002613:Cheilitis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D013472:Sunlight / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid