title: Light and laser treatment modalities for disseminated superficial actinic porokeratosis: a systematic review.
abstract: Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser and light modalities in the treatment of DSAP. A systematic review of light and laser treatment modalities was conducted to include 26 cases of patients with DSAP. Systematic review resulted in 14 articles to be included. Photodynamic therapy (PDT) overall was the least successful treatment modality, with clinical improvement seen in a minority of patients (MAL-PDT: N = 9 patients, 33.3% showed improvement; ALA-PDT: N = 3 patients, 0% improvement; hypericin-PDT: N = 2 patients, 0% improvement) after numerous post-procedural side effects of hyperpigmentation, inflammation, erythema, and discomfort. Overall, in the available reports, PDT demonstrates poor outcomes with greater incidence of side effects. The response rates of DSAP lesions treated with lasers were as follows: (Q-switched ruby lasers: N = 2, 100%; CO2laser: N = 1, 100%; PDT and CO2combination therapy: N = 2, 0-50%; erbium and neodymium YAG lasers: N = 2, 100%; fractional 1927-nm thulium fiber lasers: N = 2, 100%; Grenz rays: N = 1, 100%; and fractional photothermolysis: N = 2, 100%). The side effects of laser therapy were minimal and included mild erythema, slight hyperpigmentation, and moderate edema. Laser therapy is a promising treatment option for DSAP with an excellent side effect profile. However, higher power studies are required to determine optimal guidelines for laser treatment of DSAP.
authors.affiliation: Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, USA. GregoryAird@creighton.edu.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Aird
authors.affiliation: Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, USA.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: Sitenga
authors.affiliation: Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, USA.
authors.forename: Austin Huy
authors.initials: AH
authors.lastname: Nguyen
authors.affiliation: Creighton University School of Medicine, 2500 California Plaza, Omaha, NE, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Vaudreuil
authors.affiliation: Division of Dermatology, Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Huerter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D010789:Phototherapy; D017499:Porokeratosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: DSAP; Disseminated superficial actinic porokeratosis; Laser therapy; Light therapy; Treatment