Topical methyl-aminolevulinate photodynamic therapy using red light-emitting diode light for treatment of multiple actinic keratoses: A randomized, double-blind, placebo-controlled study.
BACKGROUND
The use of light-emitting diode light offers practical advantages in photodynamic therapy (PDT) with topical methyl-aminolevulinate (MAL) for management of actinic keratoses (AK).


OBJECTIVE
We sought to evaluate the efficacy of MAL PDT using red light-emitting diode light.


METHODS
We conducted a multicenter, double-blind, randomized study. A total of 49 patients with 363 AK lesions had 16.8% MAL cream applied under occlusion for 3 hours, and 47 patients with 360 AK lesions had vehicle cream similarly applied. The lesions were then illuminated (630 nm, light dose 37 J/cm2) with repeated treatment 1 week later. Complete lesion and patient (all lesions showing complete response) response rates were evaluated 3 months after last treatment.


RESULTS
MAL PDT was superior (P<.0001) to vehicle PDT with respect to lesion complete response (86.2% vs 52.2%, odds ratio 6.9 [95% confidence interval 4.7-10.3]) and patient complete response (59.2% vs 14.9%, odds ratio 13.2 [95% confidence interval 4.1-43.1]).


CONCLUSIONS
The study population may not be representative of all patients with AK.


CONCLUSIONS
MAL PDT using red light-emitting diode light is an appropriate treatment alternative for multiple AK lesions.
Pariser
David
D
Eastern Virginia Medical School, Division of Dermatology and Virginia Clinical Research Inc, Norfolk, Virginia 23507, USA. dpariser@pariserderm.com
Loss
Robert
R
Jarratt
Michael
M
Abramovits
William
W
Spencer
James
J
Geronemus
Roy
R
Bailin
Philip
P
Bruce
Suzanne
S
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004311:Double-Blind Method; D005148:Facial Dermatoses / Q000188:drug therapy; D005260:Female; D006801:Humans; D007642:Keratosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage*; D012536:Scalp Dermatoses / Q000188:drug therapy; D016896:Treatment Outcome
D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid