title: Comparative study of trichloroacetic acid vs. photodynamic therapy with topical 5-aminolevulinic acid for actinic keratosis of the scalp.
abstract: BACKGROUND
  Photodynamic therapy with 5-methyl-aminolevulinate and photodynamic therapy with trichloroacetic acid 50% are the two techniques utilized in the management of actinic keratosis. This study was planned to compare the efficacy, adverse effects, recurrence and cosmetic outcome of these option therapies in patients with multiple actinic keratosis of the scalp.
  
  
  METHODS
  Thirteen patients with multiple actinic keratosis were treated with one of the two treatments on half of the scalp at baseline, while the other treatment was performed on the other half 15 days apart, randomly. Efficacy, adverse effects, cosmetic outcome and recurrence were recorded at follow-up visit at 1, 3, 6 and 12 months.
  
  
  RESULTS
  Photodynamic therapy with 5 methyl-aminolevulinate was more effective than trichloroacetic acid although less tolerated by patients as it was more painful. Early adverse effects were almost the same even if trichloroacetic acid leads also to crust formation and to a worse cosmetic outcome characterized by hypopigmentation. Recurrence was lower in the area treated with photodynamic therapy.
  
  
  CONCLUSIONS
  Trichloroacetic acid 50% is less effective than photodynamic therapy with 5 methyl-aminolevulinate in the treatment of multiple actinic keratosis of the scalp although better tolerated by patients. As this technique is less painful and less expensive than photodynamic therapy, we hypothesize and suggest that more sequential treatments could lead to better results.
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Sergio
authors: S
authors: Di Nuzzo
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Chiara
authors: C
authors: Cortelazzi
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Valeria
authors: V
authors: Boccaletti
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Alfredo
authors: A
authors: Zucchi
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Maria Luisa
authors: ML
authors: Conti
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Paola
authors: P
authors: Montanari
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Claudio
authors: C
authors: Feliciani
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Giuseppe
authors: G
authors: Fabrizi
authors: Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University, Parma, Italy.
authors: Calogero
authors: C
authors: Pagliarello
mesh_terms: D000287:Administration, Topical; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012535:Scalp / Q000473:pathology*; D014238:Trichloroacetic Acid / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D017319:Photosensitizing Agents; D014238:Trichloroacetic Acid; D000622:Aminolevulinic Acid
keywords: MAL-photodynamic therapy; actinic keratosis; trichloroacetic acid