Daylight photodynamic therapy with methyl aminolaevulinate in patients with actinic keratoses: a preliminary experience in Southern Italy.

BACKGROUND

Daylight photodynamic therapy (D-PDT) is a novel modality of PDT in which the activation of the topical photosensitizer is mediated by the exposure to daylight instead of artificial light sources without the need of preliminary occlusion. This simplified modality has been found to be well tolerated. We report our experience with D-PDT in patients with actinic keratoses (AK).

METHODS

The data relative to 53 patients consecutively treated for AK with a single session of D-PDT using methyl aminolaevulinate cream were retrospectively reviewed. Most patients had grade I and/or II AK on the face and/or the scalp. Some patients had additional cutaneous lesions, including non-melanoma skin cancers, in the AK-associated field, that were simultaneously treated with D-PDT.

RESULTS

At 3 months, a complete response (AK number=0) was achieved by 54.7% of patients, and the lesion clearance rate was 82.7%. Treatment was more effective in thinner lesions, with complete clearance involving 93% of grade I AK. At 6-9 months after treatment, response was maintained in 85.7% of the lesions previously cleared, and 72.4% of the initial complete responders did not relapse. No relevant effect of D-PDT was instead observed on senile lentigo, nodular basal cell carcinoma and squamous cell carcinoma, whereas a complete response was seen in 7 of the 9 superficial basal cell carcinomas treated. Local skin reactions mostly consisted in slight erythema. Mild symptoms (burning and tingling sensations) were reported by 12 patients.

CONCLUSIONS

These preliminary results support the favorable efficacy and tolerability profile of D-PDT, which seems to be an interesting, valid, and convenient therapeutic option for AK, and possibly also for superficial basal cell carcinomas.