Pain associated with aminolevulinic acid-photodynamic therapy of skin disease - 24/08/11
Reprint requests: Edward V. Maytin, MD, PhD, Department of Dermatology/A61, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195.Abstract |
Background |
Pain during topical aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) limits the use of this treatment of skin diseases.
Objective |
We sought to summarize the effectiveness of interventions to reduce ALA-PDT–related pain, and to explore factors contributing to pain induction.
Methods |
A PubMed search was performed to identify all clinical PDT trials (2000-2008) that used ALA or methyl-ALA, enrolled at least 10 patients per trial, and used a semiquantitative pain scale.
Results |
In all, 43 articles were identified for review. Pain intensity is associated with lesion size and location and can be severe for certain diagnoses, such as plaque-type psoriasis. Results are inconsistent for the correlation of pain with light source, wavelength of light, fluence rate, and total light dose. Cooling represents the best topical intervention.
Limitations |
Pain perception differs widely between patients and can contribute to variability in the reported results.
Conclusion |
Gamma-aminobutyric acid receptors, cold/menthol receptors (transient receptor potential cation channel, subfamily M, member 8), and vanilloid/capsaicin receptors (transient receptor potential cation channel, subfamily V, member 1) may be involved in pain perception during ALA-PDT and are therefore worthy of further investigation.
Le texte complet de cet article est disponible en PDF.Key words : aminolevulinic acid, anesthesia, methyl aminolevulinic acid, pain, photodynamic therapy, substance P, vanilloid receptor
Plan
| Supported by National Institues of Health/National Cancer Institute grant CA84203. |
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| Conflicts of interest: None declared. |
Vol 61 - N° 6
P. 1033-1043 - décembre 2009 Retour au numéro
Article précédent
- Initial presentation of stasis dermatitis mimicking solitary lesions: A previously unrecognized clinical scenario
- Joshua Weaver, Steven D. Billings
- Treatment of psoriasis in patients with hepatitis C: From the Medical Board of the National Psoriasis Foundation
- Amylynne J. Frankel, Abby S. Van Voorhees, Sylvia Hsu, Neil J. Korman, Mark G. Lebwohl, Bruce F. Bebo, Alice B. Gottlieb, National Psoriasis Foundation
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