Treating Field Cancerization by Ablative Fractional Laser and Indoor Daylight: Assessment of Efficacy and Tolerability.

Objective

To assess if ablative fractional laser combined with indoor daylight photodynamic therapy are effective and safe for the treatment of skin field cancerization associated with actinic keratosis (AK).

Methods

A total of 46 patients with field cancerized skin and AK were treated by a single session of laser assisted drug delivery (LAAD) and indoor daylight photodynamic therapy (IDL-PDT). LAAD was applied using a CO2 ablative fractional laser (AFXL) and aminolevulonic acid. Thereafter, IDL-PDT was administered using a novel device that mimics the sun radiation with a total dose of 48 J/cm².

Results

All patients showed remission following subsequent to the study protocol (complete: 71.7%, partial: 28.3%). Pain scores using a visual analog scare immediately following treatments were 9.0 ± 2.0.

Conclusions

AFXL-LAAD combined with IDL-PDT is extremely effective for the treatment of skin field cancerization associated with AK. Nevertheless, the high pain scores associated with this combined approach may prove to be a limiting factor. Thus, further protocol modifications in larger scale studies are still warranted. J Drugs Dermatol. 2020;19(3):425-427. doi:10.36849/JDD.2020.4589.