- Methylaminolevulinic acid (MAL) photodynamic therapy (PDT) with half-time red-light illumination is associated with similar effectiveness and reduced pain compared with full-time illumination in patients with multiple actinic keratoses (AK).
Why this matters
- Conventional MAL PDT is effective for AK, but is associated with significant pain.
- Full-time and half-time illuminations were associated with similar rates of complete response at 3 months (85% vs 82%; P=.573) and 6 months (70% vs 65%; P=.433).
- Half-time illumination was associated with reduced pain during treatment compared with full-time illumination (mean visual analogue scale [VAS], 5.59 vs 6.41; P=.000), although this difference was not present 48 hours after treatment (mean VAS, 0.83 vs 0.90; P=.489).
- Full-time and half-time illumination were associated with similar rates of adverse effects.
- Erythema VAS, 1.41 vs 1.24; P=.202.
- Edema VAS, 0.34 vs 0.38; P=.712.
- Crusts VAS, 0.55 vs 0.59; P=.745.
- Blister VAS, 0.24 vs 0.14; P=.264.
- Of 774 AK lesions (29 patients) treated with MAL PDT, 385 were treated with a full-time protocol (8 minutes) and 289 were treated with a half-time protocol (4 minutes).
- Funding: None.
- Small patient sample size.
- Method of evaluating adverse effects not well validated.