Photodynamic therapy of acne vulgaris using 5-aminolevulinic acid versus methyl aminolevulinate.
BACKGROUND
Recent studies have shown that photodynamic therapy (PDT) is effective in the treatment of acne vulgaris. No studies have compared the treatment effect of aminolevulinic acid-PDT (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT).


OBJECTIVE
We sought to compare the treatment effect and tolerability of ALA-PDT versus MAL-PDT in the treatment of acne vulgaris in a controlled randomized investigator-blinded trial.


METHODS
Fifteen patients with at least 12 facial inflammatory acne lesions had one split-face PDT treatment with MAL and ALA.


RESULTS
Twelve weeks after treatment we found a 59% decrease in inflammatory lesions from baseline, with no significant differences in effectiveness between the two treatments. All patients experienced moderate to severe pain during illumination and developed erythema, pustular eruptions, and epithelial exfoliation after treatment, which were more severe and uniform in the ALA-PDT-treated area.


CONCLUSIONS
The study is paired and controlled, but the results should be evaluated with consideration given for the number of participating patients.


CONCLUSIONS
PDT appeared to be an effective treatment for inflammatory acne vulgaris with no significant differences in the response rate between ALA-PDT and MAL-PDT. ALA-PDT resulted in more prolonged and severe adverse effects after treatment.
Wiegell
Stine Regin
SR
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. srw01@bbh.hosp.dk
Wulf
Hans Christian
HC
D000152:Acne Vulgaris / Q000188:drug therapy* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000622:Aminolevulinic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D006801:Humans; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage*
D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid