British Journal of Dermatology
British Journal of Dermatology
4 years ago

Photodynamic therapy is more effective than imiquimod for actinic keratosis in organ transplant recipients – a randomized intra-individual controlled trial

M. Hædersdal, A M. Wennberg, K. Togsverd-Bo, S. S. Sørensen, C. Sandberg, H. C. O. Wulf, C. Halldin, H. Gonzalez
Background Actinic keratoses (AKs) in solid organ transplant recipients (OTRs) are difficult-to-treat pre-malignancies and comparison of topical therapies is therefore warranted. Objectives In an intra-individual study to compare efficacy and safety of field treatment with methyl aminolevulinate photodynamic therapy (MAL-PDT) and imiquimod (IMIQ) for AKs in OTRs. Materials and methods OTRs (n=35) with 572 AKs (grade I-III) in two similar areas in the face, scalp, dorsal hands or forearms were included. All patients received one MAL-PDT and one IMIQ session (3 weekly applications for 4 weeks) in each study area according to randomization. Treatments were repeated after 2 months (IMIQ) and 3 months (PDT) in skin with incomplete AK-response. Outcome measures were complete lesion response (CR), skin reactions, laboratory results and treatment preference. Results The majority of study areas received two treatment sessions (PDT n=25, IMIQ n=29 patients). At 3 months after two treatments, PDT-treated skin achieved higher CR (AK I-III, median 78%, range 50-100%) compared to IMIQ-treated skin areas (median 61%, range 33-100%, p <0.001). Fewer emergent AKs were seen in PDT- vs. IMIQ-treated skin (0.7 vs. 1.5 AK, p=0.04). Patients developed more intense inflammatory skin reactions following PDT (PDT 2.8, IMIQ 1.7, p<0.01) that resolved faster compared to IMIQ (median 10 vs. 18 days, p<0.01). Patient preference (p= 0.47) and cosmesis (p>0.30) were similar for PDT and IMIQ. No significant changes in laboratory results were observed. Conclusion Compared to IMIQ, PDT-treatment obtained higher AK clearance at 3-month follow-up and shorter-lasting, but more intense short-term skin reactions. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/bjd.15884

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.