title: Pulse photodynamic therapy reduces inflammation without compromising efficacy in the treatment of multiple mild actinic keratoses of the face and scalp: a randomized clinical trial.
abstract: BACKGROUND
  The main side-effects of photodynamic therapy (PDT) for actinic keratoses (AKs) are post-treatment erythema and oedema, and pain during illumination. Severe erythema after PDT enhances the down time associated with the treatment.
  
  
  OBJECTIVE
  To evaluate in a randomized intraindividual study whether pulse-PDT and corticosteroid pulse-PDT would reduce treatment-induced erythema compared with conventional PDT.
  
  
  METHODS
  Twenty-two patients with multiple mild AKs on the face and scalp were treated with methyl aminolaevulinate (MAL)-PDT in three similar areas. Two areas were incubated with MAL for 30 min (pulse-PDT) and one area was incubated with MAL for 3 h (conventional PDT). All areas were illuminated with red light after 3 h. In one of the pulse-PDT areas a superpotent corticosteroid was applied before and just after PDT (S-pulse-PDT).
  
  
  RESULTS
  Pulse-PDT significantly reduced PDT-induced erythema (P = 0·020), and erythema was even further reduced by S-pulse-PDT (P < 0·001). The complete lesion response rate 3 months after PDT did not differ significantly between the three treated areas.
  
  
  CONCLUSIONS
  Pulse-PDT and S-pulse-PDT reduced erythema 24 h after treatment of multiple mild AKs on the face and scalp. The use of a short MAL application time and topical corticosteroid did not affect the efficacy of PDT and may be an easy way to make PDT treatment of large visible areas more acceptable.
authors: Department of Dermatology D92, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
authors: S R
authors: SR
authors: Wiegell
authors: Department of Dermatology D92, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
authors: B
authors: B
authors: Petersen
authors: Department of Dermatology D92, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark.
authors: H C
authors: HC
authors: Wulf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D004890:Erythema / Q000188:drug therapy; D005148:Facial Dermatoses / Q000188:drug therapy*; D005260:Female; D005453:Fluorescence; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D008297:Male; D009824:Ointments; D010146:Pain / Q000517:prevention & control; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011524:Protoporphyrins / Q000378:metabolism; D012536:Scalp Dermatoses / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009824:Ointments; D017319:Photosensitizing Agents; D011524:Protoporphyrins; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX