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Chen J, Yuan F, Zheng L, Wen L, Gao M, Zhou W, Fan X. Limitations of ALA-PDT as a reliable therapy for AK in clinical practice. Photodiagnosis Photodyn Ther 2023; 44:103797. [PMID: 37775041 DOI: 10.1016/j.pdpdt.2023.103797] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/28/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Numerous clinical studies have demonstrated the effectiveness of 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in treating actinic keratosis (AK). This therapy has achieved an average lesion clearance rate of approximately 80 % and has also shown to produce satisfactory cosmetic outcomes. However, in our clinical practice, the utilization and adherence to ALA-PDT treatment among AK patients has been lower than anticipated, possibly due to various factors. OBJECTIVE The objectives of this study are twofold: (1) To analyze the actual therapeutic effects of ALA-PDT treatment on AK lesions in clinical practice; and (2) To identify the factors that hinder acceptance of ALA-PDT therapy among AK patients with large area or multiple lesions situated on the head and face. METHOD This study included a group of 20 AK patients, comprising 15 females and 5 males, with an age range of 57-87 years. All patients received a complete course of ALA-PDT therapy, consisting of 3-6 treatments. The study analyzed various factors, including the cure rate, recurrence rate, cosmetic effects, and adverse reactions following treatment. To investigate the factors affecting the acceptance of ALA-PDT treatment among AK patients with large or multiple lesions on the head and face, we also examined a separate group of 43 AK patients. This group included individuals who either had incomplete courses of ALA-PDT treatment or declined the therapy for the first time. The factors potentially influencing patients' acceptance of PDT were analyzed based on the outcomes of these investigations. RESULT Among the 20 patients who completed the full course of ALA-PDT treatment, the cure rate was 95 % (19/20). The recurrence rates at 1 month, 3 months, and 6 months were 0 %, 5 %, and 10 %, respectively. Out of the 19 cured patients, only 2 experienced heavy pigmentation, and no scarring was reported 1-3 months post-treatment. Based on the survey of 43 patients who either had an incomplete course of ALA-PDT treatment or declined the therapy initially, several factors were identified as limiting their choice of PDT therapy. These factors include: (1) Intolerable adverse effects of treatment. (2) Higher treatment cost than expected. (3) Inconvenient transportation. (4) Coexistence of other senile diseases. (5) Unsatisfactory clinical efficacy observed. (6) Inadequate understanding of AK. (7) Lost to follow-up. CONCLUSION The study concludes that ALA-PDT is a beneficial and aesthetically pleasing treatment for AK patients, particularly those with extensive or multiple lesions on the head and face. However, various factors can impede the selection of ALA-PDT therapy, potentially depriving patients of the most suitable option. The study aims to assist dermatologists and AK patients in considering treatment plans and exploring alternative options. Overall, the findings of this study may provide valuable guidance for improving treatment outcomes and patient satisfaction.
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Affiliation(s)
- Jingjing Chen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui, China; Institute of Dermatology, Anhui Medical University, Hefei 230022, Anhui, China; Department of Dermatology, Anhui Provincial Corps Hospital of Chinese People's Armed Police Forces, Hefei 230001, Anhui, China
| | - Feng Yuan
- Department of Dermatology, Anhui Provincial Corps Hospital of Chinese People's Armed Police Forces, Hefei 230001, Anhui, China
| | - Liyun Zheng
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui, China; Institute of Dermatology, Anhui Medical University, Hefei 230022, Anhui, China
| | - Leilei Wen
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui, China; Institute of Dermatology, Anhui Medical University, Hefei 230022, Anhui, China
| | - Min Gao
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui, China; Institute of Dermatology, Anhui Medical University, Hefei 230022, Anhui, China
| | - Wenming Zhou
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui, China; Institute of Dermatology, Anhui Medical University, Hefei 230022, Anhui, China.
| | - Xing Fan
- Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, Anhui, China; Institute of Dermatology, Anhui Medical University, Hefei 230022, Anhui, China.
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Zhang G, Cao Z, Wang P, Zhu L, Zhang L, Zho Z, Shi L, Wang X. Comparison of efficacy, adverse effects and costs between 20 % ALA-PDT and 10 % ALA-PDT for the treatment of actinic keratosis in Chinese patients. Photodiagnosis Photodyn Ther 2020; 31:101605. [DOI: 10.1016/j.pdpdt.2019.101605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 01/10/2023]
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Gerkowicz A, Bartosińska J, Wolska-Gawron K, Michalska-Jakubus M, Kwaśny M, Krasowska D. Application of superluminescent diodes (sLED) in the treatment of scarring alopecia – A pilot study. Photodiagnosis Photodyn Ther 2019; 28:195-200. [DOI: 10.1016/j.pdpdt.2019.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 09/08/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022]
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