title: Laser-mediated Photodynamic Therapy: An Alternative Treatment for Actinic Keratosis?
abstract: Photodynamic therapy (PDT) with light emitting diode (LED) illumination is a frequently used treatment modality for actinic keratosis (AK) with excellent cosmetic outcome. A major disadvantage, however, is the high pain score. Pulsed dye laser (PDL) illumination has been suggested, but the long-term efficacy of this treatment is unknown. In this split-face study we prospectively treated 61 patients with AK, with both LED-PDT and PDL-PDT. The mean change in the number of lesions between the end of follow-up and start of therapy was -4.25 (95% confidence interval (95% CI) -5.07; -3.43) for LED-PDT and -3.88 (95% CI -4,76; -2.99) for PDL-PDT, with a non-significant difference (p = 0.258) of -0.46 (95% CI -1.28; 0.35). The percentage decrease from baseline in the total number of AK was 55.8% and 47.8%, respectively, at 12-month follow-up. Visual analogue scale pain score was lower after PDL (mean 2.64) compared with LED illumination (mean 6.47). These findings indicate that PDL-PDT is an effective alternative illumination source fo.
authors.affiliation: Department of Dermatology, Maastricht University Medical Centre, Maastricht, The Netherlands. janneke.kessels@mumc.nl.
authors.forename: Janneke P H M
authors.initials: JP
authors.lastname: Kessels
authors.forename: Patty J
authors.initials: PJ
authors.lastname: Nelemans
authors.forename: Klara
authors.initials: K
authors.lastname: Mosterd
authors.forename: Nicole W J
authors.initials: NW
authors.lastname: Kelleners-Smeets
authors.forename: Gertruud A M
authors.initials: GA
authors.lastname: Krekels
authors.forename: Judith U
authors.initials: JU
authors.lastname: Ostertag
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000628:therapy*; D054025:Lasers, Dye / Q000009:adverse effects; D028022:Low-Level Light Therapy / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D057240:Patient Preference; D010778:Photochemotherapy / Q000009:adverse effects / Q000295:instrumentation*; D017319:Photosensitizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid