Protoporphyrin IX formation after application of methyl aminolevulinate on the face and scalp with and without prior curettage
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Protoporphyrin IX formation after application of methyl aminolevulinate on the face and scalp with and without prior curettage. / Heerfordt, Ida M; Bieliauskiene, Giedre; Wulf, Hans Christian.
I: Photodiagnosis and Photodynamic Therapy, Bind 22, 2018, s. 155-157.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Protoporphyrin IX formation after application of methyl aminolevulinate on the face and scalp with and without prior curettage
AU - Heerfordt, Ida M
AU - Bieliauskiene, Giedre
AU - Wulf, Hans Christian
N1 - Copyright © 2018 Elsevier B.V. All rights reserved.
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Pulse photodynamic therapy (PDT) is carried out as classical PDT except that methyl aminolaevulinate (MAL) is removed after 30 min. Protoporphyrin IX (PpIX) accumulation becomes lower after 3 h in pulse-PDT than in classical PDT, but pulse-PDT still has full treatment effect on actinic keratosis (AK). The present study aimed to investigate when PpIX formation in classical PDT without curettage reaches the PpIX level in pulse-PDT with curettage in the skin of the face and scalp.METHODS: Fourteen patients with AKs in the face and scalp were included in this pilot study. Each patient had two fields randomly allocated to two different regimes: (i) continuing MAL incubation without prior curettage (-Cur) and (ii) 30 min MAL incubation after curettage (+Cur). The PpIX level in each field was measured with a hand-held fluorescence photometer every 30 min for 6 h after MAL application. No illumination was performed.RESULTS: The median PpIX level in the +Cur field after 3 h was 22 arbitrary units (AU), which represents the amount of PpIX that could have been photobleached after pulse-PDT with maximal treatment effect. After 3 h the median PpIX level in the -Cur field was 20 AU, which was not significantly different from the level in the +Cur field (p = 0.9).CONCLUSIONS: We propose PDT without curettage as follows: 3 h of MAL incubation and subsequently sufficient illumination. The treatment effect of this regime should be tested to verify if curettage of the face and scalp area may be omitted in PDT.
AB - BACKGROUND: Pulse photodynamic therapy (PDT) is carried out as classical PDT except that methyl aminolaevulinate (MAL) is removed after 30 min. Protoporphyrin IX (PpIX) accumulation becomes lower after 3 h in pulse-PDT than in classical PDT, but pulse-PDT still has full treatment effect on actinic keratosis (AK). The present study aimed to investigate when PpIX formation in classical PDT without curettage reaches the PpIX level in pulse-PDT with curettage in the skin of the face and scalp.METHODS: Fourteen patients with AKs in the face and scalp were included in this pilot study. Each patient had two fields randomly allocated to two different regimes: (i) continuing MAL incubation without prior curettage (-Cur) and (ii) 30 min MAL incubation after curettage (+Cur). The PpIX level in each field was measured with a hand-held fluorescence photometer every 30 min for 6 h after MAL application. No illumination was performed.RESULTS: The median PpIX level in the +Cur field after 3 h was 22 arbitrary units (AU), which represents the amount of PpIX that could have been photobleached after pulse-PDT with maximal treatment effect. After 3 h the median PpIX level in the -Cur field was 20 AU, which was not significantly different from the level in the +Cur field (p = 0.9).CONCLUSIONS: We propose PDT without curettage as follows: 3 h of MAL incubation and subsequently sufficient illumination. The treatment effect of this regime should be tested to verify if curettage of the face and scalp area may be omitted in PDT.
KW - Aged
KW - Aged, 80 and over
KW - Aminolevulinic Acid/administration & dosage
KW - Curettage
KW - Face
KW - Female
KW - Humans
KW - Keratosis, Actinic/drug therapy
KW - Male
KW - Middle Aged
KW - Photochemotherapy/methods
KW - Photosensitizing Agents/administration & dosage
KW - Pilot Projects
KW - Protoporphyrins/pharmacokinetics
KW - Scalp
U2 - 10.1016/j.pdpdt.2018.03.008
DO - 10.1016/j.pdpdt.2018.03.008
M3 - Journal article
C2 - 29601904
VL - 22
SP - 155
EP - 157
JO - Photodiagnosis and Photodynamic Therapy
JF - Photodiagnosis and Photodynamic Therapy
SN - 1572-1000
ER -
ID: 224245999