title: Efficacy of photodynamic therapy with laser pretreatment for actinic keratosis and photorejuvenation as evaluated by fluorescent imaging.
abstract: BACKGROUND
  The Methylaminolevulinate-photodynamic therapy (MAL-PDT) has been reported to be effective in treating actinic keratosis (AK). Fluorescent images taken after topical MAL application have been used to diagnose cancerous lesions.
  
  
  OBJECTIVE
  We evaluated therapeutic efficacy of MAL-PDT for multiple AK and defined value of fluorescent images in evaluating treatment response. We also investigated photorejuvenation effects of PDT.
  
  
  METHODS
  Ten patients with multiple AK were enrolled. We did histological confirmation of the lesion by biopsy. After 3 h of MAL cream occlusion, red light was illuminated with 37 J/cm(2) on 0, 4, 16, and 20 weeks. At each visit, lesions were counted by inspection and fluorescent images were taken under ultraviolet A light. We repeated skin biopsy in 16 weeks.
  
  
  RESULTS
  All patients showed significant improvement after three sessions of PDT. The average remission rate was 85.96%. Overall, patients showed significant improvement in photoaging such as erythema, coarse wrinkles, and skin roughness. Histological examination also showed improvement. There was meaningful agreement between lesion count by fluorescent imaging and inspection (coefficient = 0.9).
  
  
  CONCLUSIONS
  PDT was found to be effective, well-tolerated, cosmetically acceptable for AK treatment and photorejuvenation, both clinically and histologically. In addition, fluorescent images taken after MAL application aided in evaluation of treatment response as well as diagnosis.
authors.affiliation: Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Kim
authors.forename: Noo Ri
authors.initials: NR
authors.lastname: Lee
authors.forename: Sang-Yeon
authors.initials: SY
authors.lastname: Park
authors.forename: Minseob
authors.initials: M
authors.lastname: Eom
authors.forename: Eung Ho
authors.initials: EH
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004890:Erythema / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging; D010778:Photochemotherapy; D015595:Skin Aging / Q000187:drug effects
keywords: actinic keratosis (AK); fluorescent imaging; methylaminolevulinate-photodynamic therapy (MAL-PDT); photorejuvenation