Combination of Laser Therapy and Photodynamic Therapy with 5-Aminolevulinic Acid Patch for the Treatment of Actinic Cheilitis.

Background

Actinic cheilitis (AC) is a premalignant lesion of the lips that can evolve into squamous cell carcinoma. Among nonsurgical treatments, photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) patch might represent a new noninvasive therapeutic approach for AC.

Objective

We sought to investigate the potential role of fractional CO2 laser pretreatment in boosting ALA penetration and distribution into AC treated with PDT.

Methods

We report a case of a woman with AC on the lower lip, treated with ablative fractional CO2 laser to boost drug delivery of 5-ALA patch before PDT treatment. Reflectance confocal microscopy was performed to assess diagnosis and treatment response.

Results

We detected a good clinical and cosmetic outcome after two applications of combined treatment. Erythema, crust, and edema were reported as side effects.

Conclusions

This case report shows that ablative fractional CO2 laser-assisted PDT might be an effective therapeutic alternative for patients with AC who refuse or are contraindicated for surgical procedures.