Innovative treatment of actinic keratoses using photodynamic therapy with 5-aminolevulinic acid.

ANDREA VIRGINIA JUAREZ; ROMINA PIZARRO; CAROLA JURGENS; CAROLINA BUSTOS FIERRO; MARÍA EUGENIA OLIVERA; MARÍA EMILIA GAVELLI; RUBÉN HILARIO MANZO; JORGE LUIS ROMERO; NÉSTOR BOETTO; CARLOS CONSIGLI

Congreso; 16th International Congress on Photobiology; 2014

Universidad nacional de Córdoba

Photodynamic therapy (PDT) is an effective first-line treatment for actinic keratosis (AK). Different light sources have been employed for PDT. These instruments are expensive and high-cost to maintain, becoming the major limitation for PDT in Argentina. Currently, clinical studies that evaluate 5- aminolevulinic acid (ALA)-PDT for AK in public hospitals in Córdoba are absent. Objective: Evaluate the effectiveness of an economical lamp developed in the Universidad Nacional de Córdoba, to be employed in PDT for treating patients with AK at the Hospital Nacional de Clinicas (HNC), Córdoba. In this nonrandomized open-label study, 5 patients (2 male and 3 female), average age 76 years (71-78) diagnosed with AK were included. The protocol was approved by the Ethics Committee of HNC. The patients presented 9 hyperpigmented and rough lesions on the face and head. The (ALA)-PDT consisted on the application of 20% extemporaneous ALA solution, compounded in the HNC pharmacy service. This solution was topically applied on the lesions and then covered with a non-occlusive dressing for 2h. Then, the lesions were uncovered and illuminated with the lamp (for treatment 15 units LEDs of 630nm and to diagnosis 12 units of 405nm), using a fluence rate of 100mW/cm2, during 4min. Outcomes measures were hyperpigmentation and roughness disappearance, being patients examined 24h, 2weeks and 1month after the treatment. The lesions were photographed before and after PDT and if it was necessary the treatment was repeated. A remission in 8 of 9 treated lesions was achieved in the first PDT-application; while the remaining lesion was reduce in the second PDT-application. Clinically, there was no significant scarring or pigmentary changes after therapy. Preliminary results obtained in this study show that the (ALA)-PDT protocol was safe and effective for the treatment AK lesions with excellent cosmetic outcome.