Photodynamic Therapy of Actinic Keratoses Using 585nm Dye Laser and Variable Lights
BACKGROUND: Incohorenet lamps or pulsed/continuous wave lasers have effectively been used for photodynamic therapy (PDT). OBJECTIVE: To assess the safety and efficacy of the various light sources, such as halogen, xenon arc, and the 585nm pulsed dye laser, in photodynamic therapy for treatment of actinic keratosis. METHODS: PDT, using 5-aminolaevulinic acid (5-ALA), was used on 18 patients who had been diagnosed with actinic keratoses. A single treatment consisting of a topical application of 20% 5-aminolaevulinic acid for 4 hours, followed by halogen, xenon arch lamp and the 585nm pulsed dye laser was administered. RESULTS: Of the 227 lesions, 95/106 (89.6%), 68/77 (88.3%), and 39/44 (88.6%) lesions showed complete response to the halogen lamp, xenon arc lamp, and 595nm dye laser respectively, and 10/106 (9.4%), 9/77 (11.7%), and 5/44 (11.4%) lesions showed partial response to the above, respectively. Only one lesion (1.0%) showed no response to the halogen lamp. In all cases, cosmetic outcome was excellent, and anatomical function was preserved. Topical 5-ALA based PDT is an effective and useful treatment modality for various premalignant diseases, to the halogen lamp, xenon arc lamp, or 585nm pulsed dye laser were used. CONCLUSIONS: Treatment of actinic keratosis with various light sources, following topical application of 5-ALA is effective. However, advantages of the laser treatment may include recovery times, excellent postreatment cosmesis, and high efficacy rate.
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