title: Clinical and echographic analysis of photodynamic therapy using methylaminolevulinate as sensitizer in the treatment of photodamaged facial skin.
abstract: OBJECTIVE
  Photodynamic therapy (PDT) using aminolevulinic acid (ALA) has been previously investigated in the treatment of photodamaged skin. The aim was to assess efficacy and tolerability of methylaminolevulinate (MAL) as a substitute for ALA in PDT treatment of actinic keratosis (AK) and photoaging.
  
  
  METHODS
  Twenty patients with multiple (n = 137) AKs and severe photodamage of the face were treated. Metvix (Galderma, France) was applied under occlusion for 3 hours before exposure to 37 J/cm(2) of red light (Aklilite CL 128, Photocure, Norway). Two treatments were given at monthly intervals.
  
  
  RESULTS
  The clearance rate of AKs was 88.3%, and global score which we use to rate photoaging, mottled hyperpigmentation, fine lines, roughness, and sallowness of the skin showed improvement, but deep wrinkles, teleangiectasia, facial erythema, and sebaceous gland hypertrophy did not change. The treatments were well tolerated. High-resolution echography showed an increase in skin thickness, pixels count and area, as well as a reduction of the subepidermal low-echogenic band (SLEB) thickness.
  
  
  CONCLUSIONS
  MAL-PDT is an effective treatment for multiple AKs. In addition, it improves clinical signs of photodamage of the surrounding skin.
authors.affiliation: Department of Dermatology, Spedali Civili Hospital, University of Brescia, Brescia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Zane
authors.forename: Rossana
authors.initials: R
authors.lastname: Capezzera
authors.forename: Raffaella
authors.initials: R
authors.lastname: Sala
authors.forename: Marina
authors.initials: M
authors.lastname: Venturini
authors.forename: Piergiacomo
authors.initials: P
authors.lastname: Calzavara-Pinton
mesh_terms: D000368:Aged; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000188:drug therapy*; D007642:Keratosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012867:Skin / Q000000981:diagnostic imaging; D015595:Skin Aging / Q000187:drug effects*; D013472:Sunlight / Q000009:adverse effects; D014463:Ultrasonography
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid