Actinic keratosis: new combinatorial treatment approach shows promise

Takeaway

• Combined daylight and conventional photodynamic therapy (combPDT) is associated with significant reductions in lesion number compared with daylight photodynamic therapy (dPDT) alone in a small study of patients with actinic keratosis (AK) of the face and scalp receiving simultaneous treatment with 5-aminolaevulinic acid nanoemulsion (BF-200 ALA).

Why this matters

• This report is the first to examine the potential benefits of this combined therapeutic approach.

Key results

• CombPDT was associated with a greater reduction in AK lesion number compared with dPDT: 82.7% vs 56.8% (P<.001).
• CombPDT was associated with increased rates of partial response compared with dPDT: 63.2% vs 26.3% (P=.04).
• CombPDT was associated with more total local skin reactions (mean, 6.4 vs 4.4; P=.015), including erythema (2.7 vs 2; P=.02) and edema (1.1 vs 0.5; P=.045), and increased pain during illumination (3.4 vs 0.6 on visual analog scale) compared with dPDT.

Study design

• 19 patients with 264 AK lesions each received 1 combPDT session and 1 dPDT session along with BF-200 ALA, and were analysed after 12 weeks.
• Funding: None.

Limitations

• Small patient sample size.