Photodynamic therapy with topical methyl aminolevulinate for actinic keratosis: Results of a prospective randomized multicenter trial
Abstract
Background Photodynamic therapy (PDT) is a promising new treatment modality for actinic keratoses. Methyl aminolevulinate (MAL) (Metvix, PhotoCure, Oslo, Norway) leads to selective accumulation of photoactive porphyrins in premalignant skin lesions and makes the lesions susceptible to phototoxic effects on illumination with red light.Objective This multicenter, randomized, double-blind study compared complete response rates, cosmetic outcome, and patient satisfaction for PDT with cream containing 160 mg/g MAL or placebo cream in the treatment of actinic keratoses.Methods After application of the cream under occlusion for 3 hours, the lesions were illuminated by noncoherent red light (570-670 nm, light dose 75 J/cm(2)). Treatment was repeated after 1 week and response was assessed 3 months later. A total of 80 patients were randomized into the study, 42 in the active and 38 in the placebo group.Results Complete lesion response rate was higher after MAL PDT than placebo, 89% versus 38% per protocol analysis (P =.001). An excellent or good cosmetic outcome was reported in more than 90% of patients treated with MAL.Conclusion In this small study, PDT using topical MAL was a safe and effective treatment for actinic keratoses with excellent cosmetic outcome. It is a promising treatment that could benefit from further study.
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MAL/PDT use with red light showed an 89% complete lesion response rate compared to a 38% placebo rate at 3 months.
“Use with red light showed an 89% complete lesion response rate compared to a 38% placebo rate at 3 months.”
From Photodynamic Therapy for Non-Melanoma Skin Cancers (2016) · cites this paper as [40]
Excellent or good cosmetic results were seen in over 90% of patients treated with MAL/PDT.
“Excellent or good cosmetic results were seen in over 90% of patients treated with MAL/PDT [40].”
From Photodynamic Therapy for Non-Melanoma Skin Cancers (2016) · cites this paper as [40]
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Methyl Aminolevulinate: Actinic Keratoses and Bowen's Disease
Morton, C. A. (2007) · Dermatologic Clinics · doi:10.1016/j.det.2006.09.009 · Cited by 55 · see citing works
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A clinical review of PDT for cutaneous malignancies
Allison, R. R., Sibata, C. H., Downie, G., & Cuenca, R. E. (2006) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2006.05.002 · Cited by 54 · see citing works
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MacCormack, M. A. (2006) · Advances in Dermatology · doi:10.1016/j.yadr.2006.09.008 · Cited by 52 · see citing works
Maytin, E. V., Kaw, U., Ilyas, M., Mack, J. A., & Hu, B. (2018) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2018.02.009 · Cited by 55 · see citing works
Olsen, C. E., Weyergang, A., Edwards, V. T., Berg, K., Brech, A., Weisheit, S., Høgset, A., & Selbo, P. K. (2017) · Biochemical Pharmacology · doi:10.1016/j.bcp.2017.08.002 · Cited by 51 · see citing works
Photodynamic Therapy in the Treatment of Actinic Keratosis†
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Therapeutic strategies for actinic keratoses – a systematic review
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Actinic Keratosis and Cutaneous Squamous Cell Carcinoma
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Photodynamic Therapy for Non-Melanoma Skin Cancer
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Photodynamic therapy in dermatology: current concepts in the treatment of skin cancer
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Terapia fotodinámica en dermatología
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The role of light in the treatment of non-melanoma skin cancer using methyl aminolevulinate
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Update on Photodynamic Treatment for Actinic Keratosis
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Treatment of actinic keratosis: a systematic review
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Photodynamic Therapy in the Treatment of Rosacea
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Verger, A., Brandhonneur, N., Molard, Y., Cordier, S., Kowouvi, K., Amela-Cortes, M., & Dollo, G. (2021) · International journal of pharmaceutics · doi:10.1016/j.ijpharm.2021.120763 · Cited by 37 · see citing works
- Authors
- Pariser, D. M., Lowe, N. J., Stewart, D. M., Jarratt, M. T., Lucky, A. W., Pariser, R. J., & Yamauchi, P. S.
- Affiliations
- Eastern Virginia Medical School (US)
- Venue
- Journal of the American Academy of Dermatology
- Publisher
- Elsevier BV
- Published
- 2003-02
- Volume
- 48
- Issue
- 2
- Pages
- 227-232
- ISSN
- 0190-9622 (ISSN-L)
- OpenAlex
- W2121049651
- Cited by
- 302
- References
- 21
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 11 · 2022: 9 · 2021: 6 · 2020: 8 · 2019: 8 · 2018: 6 · 2017: 6 · 2016: 13 · 2015: 12 · 2014: 10 · 2013: 13 · 2012: 19
- FWCI
- 14.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Academy of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Nonmelanoma Skin Cancer Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Photodynamic Therapy Research Studies
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Keywords
- photodynamic therapy, methyl aminolevulinate, actinic keratosis, topical photosensitizer, porphyrins, red light, cosmetic outcome, patient satisfaction, premalignant skin lesions
- MeSH terms
- Administration, Topical, Adult, Aged, Aged, 80 and over, Aminolevulinic Acid, Double-Blind Method, Female, Humans, Keratosis, Male, Middle Aged, Photochemotherapy, Photosensitizing Agents
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