title: Indole 3-acetic acid-photodynamic therapy in the treatment of multiple actinic keratoses: A proof of concept pilot study.
abstract: BACKGROUND
  Actinic Keratoses (AK) are considered a form of in situ Squamous Cell Carcinoma (SCC) arising on chronically photoexposed skin. PDT with ALA or MAL is an effective treatment for multiple AK due its high Overall Response Ratio (ORR) but is burdened by important drawbacks: time-consumption, pain and high costs. Indole-3 acetic acid (IAA) is a newly described photosensitizer with proven clinical efficacy on seborrheic dermatitis and acne vulgaris. The aim of the study was to assess efficacy, safety and tolerability of a cycle of IAA-PDT at 0.015% in liposomal gel in the treatment of multiple AK of face or scalp.
  
  
  METHODS
  We treated 12 patients affected by multiple AK on face/scalp with 4 weekly applications. The product was applied for 15min under occlusion; medicated area was then irradiated for 15min with a LED light at 520nm wavelength for a total fluency of 9J/cm2.
  
  
  RESULTS
  No grade 3/4 SAE have been reported; all 12 patients successfully completed the cycle. CR at 3 months follow-up was 25%, with an ORR of 50%. Patients reported almost no pain during irradiations, with mean overall Visual Analogic Scale (VAS) score of 0.3±0.7. IAA-PDT led to a significant improve on Disease Life Quality Index (DLQI) mean score, but no variations on Actinic Keratosis Quality of Life (AKQoL) mean score.
  
  
  CONCLUSIONS
  Although larger studies are needed, this is a first "proof of concept" of IAA- PDT as a possible treatment for multiple AK on face/scalp.
authors: Department of Surgery and Translational Medicine, Division of Dermatology, University of Florence Medical School, Florence, Italy. Electronic address: vieri.grandi@unifi.it.
authors: Vieri
authors: V
authors: Grandi
authors: Department of Surgery and Translational Medicine, Division of Dermatology, University of Florence Medical School, Florence, Italy.
authors: Irene
authors: I
authors: Baldi
authors: Department of Surgery and Translational Medicine, Division of Dermatology, University of Florence Medical School, Florence, Italy.
authors: Pietro
authors: P
authors: Cappugi
authors: Department of Surgery and Translational Medicine, Division of Dermatology, University of Florence Medical School, Florence, Italy.
authors: Moira
authors: M
authors: Mori
authors: Department of Surgery and Translational Medicine, Division of Dermatology, University of Florence Medical School, Florence, Italy.
authors: Nicola
authors: N
authors: Pimpinelli
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007210:Indoleacetic Acids / Q000008:administration & dosage*; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D010865:Pilot Projects; D012536:Scalp Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D007210:Indoleacetic Acids; D017319:Photosensitizing Agents; C030737:indoleacetic acid
keywords: Actinic keratosis; Auxine; Indole; Indole 3 acetic acid; Non melanoma skin cancer; Photodynamic therapy