Factors related to pain during routine photodynamic therapy: a descriptive study of 301 patients.
BACKGROUND
Pain may be a limiting factor in the use of photodynamic therapy (PDT). The consequences of the pain i.e. the resources spent on pain-intervention during routine PDT therapy are poorly described.


OBJECTIVE
To describe the consequences of pain during PDT by describing the use of pain-reducing interventions in routine use. We studied the frequency as well as level of pain-reducing intervention.


METHODS
Descriptive data from PDT treated patients. The level of pain-reducing intervention was graded 0, no intervention; +, cold water spray and ++, pause or nerve block.


RESULTS
Data from 983 PDT treatments on 579 lesions distributed on 301 patients: 56% did not require pain-reducing intervention, 35% required spraying of cold water, while 9% required pause or nerve block. Ordinate logistic regression revealed an association between lesion size and pain-reducing intervention: the larger the lesion, the more frequent the intervention. Lesion size did not, however, appear associated with the level of intervention. Intervention was most frequently required when treating the scalp/forehead and the extremities. The scalp/forehead also required the highest level of intervention. No significant association between pain-reducing intervention and diagnosis, pre-treatment, gender or age was found.


CONCLUSIONS
Pain-reducing intervention was required in 44% of the PDT treatments. Intervention was particularly required when treating lesions in areas suited for PDT therapy for cosmetic reasons such as the scalp/forehead or extremities. Treatment of large areas more frequently calls for pain intervention than treatment of small areas.
Department of Dermatology, Health Sciences Faculty, Roskilde Hospital, University of Copenhagen, Denmark. miller@dadlnet.dk
I M
IM
Miller
J S
JS
Nielsen
S
S
Lophaven
G B E
GB
Jemec
D006801:Humans; D010146:Pain / Q000209:etiology*; D010778:Photochemotherapy / Q000009:adverse effects*; D012189:Retrospective Studies