title: Topical photodynamic therapy with porphyrin precursors--assessment of treatment-associated pain in a retrospective study.
abstract: Photodynamic therapy (PDT) with aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) is an approved modality for the non-invasive treatment of actinic keratoses (AK) and basal cell carcinoma (BCC) offering excellent cosmetic outcome. However, pain during and after illumination is the most frequent and limiting side effect. The aim of this study was to precisely assess how reported pain during PDT is influenced by sex, age, treatment site, disease (AK/BCC) as well as the photosensitizer used. 467 lesions consisting of AK (primary treatments: n=158; follow-up: n=47) or BCC (primary treatments: n=138; follow-up: 124) were treated by ALA- or MAL-PDT using metal halide lamps (580-750 nm). Pain was assessed during illumination using a continuous visual analogue scale (VAS). Factors predictive for higher pain levels during PDT are treatment of the head, treating AK and using ALA. The observed results may improve patient management and predict which level of pain to expect, and what kind of pain relief to prepare.
authors.affiliation: Department of Dermatology, Regensburg University Hospital, D-93042, Regensburg, Germany.
authors.forename: Julia Maria
authors.initials: JM
authors.lastname: Steinbauer
authors.forename: Stephan
authors.initials: S
authors.lastname: Schreml
authors.forename: Philipp
authors.initials: P
authors.lastname: Babilas
authors.forename: Florian
authors.initials: F
authors.lastname: Zeman
authors.forename: Sigrid
authors.initials: S
authors.lastname: Karrer
authors.forename: Michael
authors.initials: M
authors.lastname: Landthaler
authors.forename: Rolf-Markus
authors.initials: RM
authors.lastname: Szeimies
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use; D002280:Basal Cell Carcinoma / Q000188:drug therapy*; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies; D012737:Sex Factors
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid