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Painless photodynamic therapy for facial actinic keratoses: A retrospective cohort study of the post-treatment inflammatory response.
- Source :
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Photodiagnosis and photodynamic therapy [Photodiagnosis Photodyn Ther] 2024 Feb; Vol. 45, pp. 103838. Date of Electronic Publication: 2023 Oct 14. - Publication Year :
- 2024
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Abstract
- Introduction: Photodynamic therapy (PDT) is a safe, non-mutagenic, and non-scarring treatment for actinic keratoses (AK).<br />Background: 'Painless' photodynamic therapy (p-PDT) is a regimen for AK that employs simultaneous aminolevulinate incubation and blue light illumination. The efficacy of p-PDT resembles that of traditional PDT, but detailed mechanisms of action for p-PDT are not well understood.<br />Methods: To characterize the inflammatory effects of the p-PDT procedure 48 h following treatment and determine the association of inflammation with precancer burden, we performed a retrospective cohort study of 104 patients with AK of face or scalp treated with p-PDT between 2017 and 2019. Patients self-reported their side effects 48 h following p-PDT and took photographs of their face and scalp. Photographs were edited to define seven anatomic regions, and erythema was scored by four investigators.<br />Results: Ninety-eight patients provided photographs suitable for erythema evaluation. Most patients experienced 2 or more side effects and some pain 48 h post-procedure. Females experienced more pain (p = 0.01) and side effects (p = 0.002) compared to males. AK burden was positively associated with post p-PDT erythema response (p < 0.0001) at all sites, but particularly in the temples (p = 0.002) and supralabial area (p = 0.009).<br />Discussion: This study confirms a strong clinical inflammatory response after p-PDT. Severity of inflammation is positively associated with AK tumor burden, suggesting that post-treatment inflammation may be a pre-requisite for p-PDT efficacy. Interestingly, the results also identify certain gender-related differences in the severity of side effects experienced by patients post-PDT.<br />Competing Interests: Declaration of Competing Interest None declared.<br /> (Copyright © 2023. Published by Elsevier B.V.)
Details
- Language :
- English
- ISSN :
- 1873-1597
- Volume :
- 45
- Database :
- MEDLINE
- Journal :
- Photodiagnosis and photodynamic therapy
- Publication Type :
- Academic Journal
- Accession number :
- 37844787
- Full Text :
- https://doi.org/10.1016/j.pdpdt.2023.103838