A randomized comparative study of tolerance and satisfaction in the treatment of actinic keratosis of the face and scalp between 5% imiquimod cream and photodynamic therapy with methyl aminolaevulinate.
BACKGROUND
Photodynamic therapy (PDT) and imiquimod are two excellent treatments for actinic keratosis but are often not well tolerated by patients.


OBJECTIVE
To ascertain which treatment is better tolerated and which produces greater patient satisfaction. A secondary objective was to determine the factors related to the patient's tolerance to each treatment.


METHODS
Patients with at least five actinic keratosis lesions on the face and scalp were selected. The patients were randomized to receive treatment with PDT with methyl aminolaevulinate or treatment with imiquimod. Tolerance, satisfaction and predisposition to repeat the treatment were evaluated.


RESULTS
Most patients exhibited good or acceptable tolerance to both PDT and imiquimod treatment. There was a higher percentage of patients treated with PDT (93%) who were very satisfied compared with imiquimod (62%) (P=0·004). Most patients treated with either one of the two options would repeat the same treatment. No significant relationship was found between age, sex, working time exposed to the sun, phototype and hair colour and the tolerance to both treatments.


CONCLUSIONS
Both PDT and imiquimod are treatments that are generally well tolerated. While both treatments provide a high level of satisfaction, PDT appears to be slightly superior in this regard.
Department of Dermatology, Instituto Valenciano de Oncología, c/Profesor Beltran Baguena 8, Valencia 46009, Spain. cserraguillen@gmail.com
C
C
Serra-Guillen
E
E
Nagore
L
L
Hueso
B
B
Llombart
C
C
Requena
O
O
Sanmartín
R
R
Botella-Estrada
C
C
Guillen
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000634:Aminoquinolines / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005148:Facial Dermatoses / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077271:Imiquimod; D007223:Infant; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D012536:Scalp Dermatoses / Q000188:drug therapy*; D055815:Young Adult
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid; D000077271:Imiquimod