Médecine

Paramédical

Autres domaines


S'abonner

A regimen to minimize pain during blue light photodynamic therapy of actinic keratoses: Bilaterally controlled, randomized trial of simultaneous versus conventional illumination - 13/03/20

Doi : 10.1016/j.jaad.2019.09.010 
Urvashi Kaw, MD a, Muneeb Ilyas, DO a, Taylor Bullock, BS a, Lisa Rittwage, BSN, RN a, Margo Riha, BSN, RN a, Allison Vidimos, MD, MPh a, Bo Hu, PhD b, Christine B. Warren, MD, MS a, Edward V. Maytin, MD, PhD a,
a Department of Dermatology, Cleveland Clinic, Cleveland, Ohio 
b Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio 

Correspondence to: Edward V. Maytin, MD, PhD, Desk A60, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 4415.Desk A60, Cleveland Clinic9500 Euclid AveClevelandOH4415

Abstract

Background

Blue light photodynamic therapy (PDT) is effective for actinic keratosis, but many patients experience stinging pain during illumination.

Objective

To compare a conventional regimen (1 hour of 5-aminolevulinic acid [ALA] preincubation, followed by blue light) versus a new modified regimen in which blue light is started immediately after ALA application.

Methods

A clinical trial with a bilaterally controlled, intrapatient study design was conducted with 23 patients. Topical 20% ALA was applied to the entire face and/or scalp. On 1 side of the body, blue light was started immediately and continued for either 30, 45, or 60 minutes (simultaneous PDT). On the contralateral side, the blue light began 1 hour after ALA application and lasted 1000 seconds (conventional PDT). Pain was evaluated on a scale from 0 to 10. Actinic keratosis lesion counts were determined by clinical examination and photography.

Results

All patients experienced significantly less pain during simultaneous illumination than during the conventional regimen. At 3 months after treatment, lesion clearance was nearly identical on the 2 sides, as determined by statistical testing of noninferiority ± 15% margin.

Limitations

Although bilaterally controlled, the study was relatively small. Additional studies are recommended.

Conclusion

The modified PDT regimen is essentially painless, yet it provides treatment efficacy similar to a conventional regimen.

Le texte complet de cet article est disponible en PDF.

Key words : clinical research, oncology, phototherapy, skin cancer, therapeutics

Abbreviations used : AK, ALA, PDT, PpIX


Plan


 Funding sources: Supported by the Cleveland Clinic Research Protocol Committee fund (to Dr Maytin), Sun/DUSA Pharmaceuticals, investigator-initiated grant (to Dr Maytin), and grant number P01CA084203 (Drs Hasan and Maytin) from the National Cancer Institute of the National Institutes of Health, USA.
 Conflicts of interest: None disclosed.
 IRB approval status: Reviewed and approved by Cleveland Clinic institutional review board (approval no. 14-374).
 Reprints not available from the authors.


© 2019  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 82 - N° 4

P. 862-868 - avril 2020 Retour au numéro
Article précédent Article précédent
  • BP180-specific IgG is associated with skin adverse events, therapy response, and overall survival in non-small cell lung cancer patients treated with checkpoint inhibitors
  • Omar Hasan Ali, David Bomze, Sandra S. Ring, Fiamma Berner, Mirjam Fässler, Stefan Diem, Marie-Therese Abdou, Christoph Hammers, Shirin Emtenani, Anne Braun, Antonio Cozzio, Bernhard Mani, Wolfram Jochum, Enno Schmidt, Detlef Zillikens, Christian D. Sadik, Lukas Flatz
| Article suivant Article suivant
  • Greater efficacy of SPF 100+ sunscreen compared with SPF 50+ in sunburn prevention during 5 consecutive days of sunlight exposure: A randomized, double-blind clinical trial
  • Indermeet Kohli, Cynthia L. Nicholson, Joshua D. Williams, Alexis B. Lyons, InSeok Seo, Prithwiraj Maitra, Xiaoyan Tian, Evren Atillasoy, Henry W. Lim, Iltefat H. Hamzavi

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.