Intraindividual, right-left comparison of topical 5-aminolevulinic acid photodynamic therapy vs. 5% imiquimod cream for actinic keratoses on the upper extremities.
Title | Intraindividual, right-left comparison of topical 5-aminolevulinic acid photodynamic therapy vs. 5% imiquimod cream for actinic keratoses on the upper extremities. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Sotiriou, E., Apalla Z., Maliamani F., Zaparas N., Panagiotidou D., & Ioannides D. |
Journal | J Eur Acad Dermatol Venereol |
Volume | 23 |
Issue | 9 |
Pagination | 1061-5 |
Date Published | 2009 Sep |
ISSN | 1468-3083 |
Keywords | Administration, Topical, Aged, Aminolevulinic Acid, Aminoquinolines, Dose-Response Relationship, Drug, Female, Humans, Imiquimod, Interferon Inducers, Keratosis, Actinic, Male, Middle Aged, Ointments, Patient Satisfaction, Photochemotherapy, Photosensitizing Agents, Treatment Outcome, Upper Extremity |
Abstract | BACKGROUND: Actinic keratoses (AKs) are considered as in situ squamous cell carcinoma. Early and effective treatment is important. Objective To compare the efficacy, cosmetic outcome and patient preference of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) with that of 5% imiquimod (IMIQ) cream in patients with AKs on the dorsa of hands and forearms.METHODS: Subjects received two ALA-PDT treatment sessions and one or two courses of imiquimod (three times per week for 4 weeks each). Treatments were randomly allocated to alternate upper extremities. Assessments included lesion response one and six months after treatment, cosmetic outcome evaluated by the investigators and patients' preference 6 months after treatment. Efficacy end point included the individual AK lesion clearance rate.RESULTS: Thirty patients with 256 lesions were included in the study. At the first follow-up, treatment with ALA-PDT resulted in significantly larger rate of cured lesions relative to 5% IMIQ cream (70.16% vs. 18.26%). At the second follow-up both treatments showed a high rate of cured lesions (65.32% for PDT vs. 55.65% for IMIQ cream). Response rates obtained in grade I lesions were higher for both treatments (71.64% for PDT vs. 72.13% for IMIQ), while treatment with PDT resulted in a significant larger rate of cured grade II lesions (57.89% for PDT vs. 37.03 for IMIQ). Difference in cosmetic outcome was not statistically significant. Results for subject preference favoured ALA-PDT.CONCLUSIONS: Our study shows that ALA-PDT and 5% IMIQ cream are both attractive treatment options for upper extremities AKs with comparable efficacy and cosmetic outcomes. |
DOI | 10.1111/j.1468-3083.2009.03259.x |
Alternate Journal | J Eur Acad Dermatol Venereol |
PubMed ID | 19470041 |