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Göteborgs universitets publikationer

Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study

Författare och institution:
Ann-Marie Wennberg (Institutionen för kliniska vetenskaper, sektionen för hud, plastik och öron); Bo Stenquist (Institutionen för kliniska vetenskaper, sektionen för hud, plastik och öron); E Stockfleth (-); S. Keohane (-); J.T Lear (-); G. Jemec (-); C. Mork (-); E. Christensen (-); A. Kapp (-); H. Solvsten (-); T. Talme (-); B. Berne (-); T. Forschner (-)
Publicerad i:
Transplantation, 86 ( 3 ) s. 423-9
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
BACKGROUND: Organ transplant recipients on long-term immunosuppressive therapy are at increased risk of non-melanoma skin lesions. Repeated field photodynamic therapy using topical methyl aminolevulinate (MAL) may have potential as a preventive treatment. METHODS: This open randomized, intrapatient, comparative, multicenter study included 81 transplant recipients with 889 lesions (90% actinic keratoses (AK)]. In each patient, the study treatment was initially administered to one 50 cm area on the face, scalp, neck, trunk, or extremities (n=476 lesions) twice (1 week apart), with additional single treatments at 3, 9, and 15 months. On each occasion, the area was debrided gently and MAL cream (160 mg/g) applied for 3 hr, before illumination with noncoherent red light (630 nm, 37 J/cm2). The control, 50 cm2 area (n=413 lesions) received lesion-specific treatment (83% cryotherapy) at baseline and 3, 9, and 15 months. Additionally, all visible lesions were given lesion-specific treatment 21 and 27 months in both treatment and control areas. RESULTS: At 3 months, MAL photodynamic therapy significantly reduced the occurrence of new lesions (65 vs. 103 lesions in the control area; P=0.01), mainly AK (46% reduction; 43 vs. 80; P=0.006). This effect was not significant at 27 months (253 vs. 312; P=0.06). Hypopigmentation, as assessed by the investigator, was less evident in the treatment than control areas (16% vs. 51% of patients; P<0.001) at 27 months. CONCLUSION: Our results suggest that repeated field photodynamic therapy using topical MAL may prevent new AK in transplant recipients although further studies are needed.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Dermatologi och venereologi
Administration, Topical, Adult, Aged, Aminolevulinic Acid/administration & dosage/adverse effects/*analogs &, derivatives/therapeutic use, Cryotherapy, Europe, Female, Humans, Immunosuppressive Agents/*adverse effects, Keratosis/chemically induced/pathology/*prevention & control, Male, Middle Aged, *Organ Transplantation, *Photochemotherapy/adverse effects, Photosensitizing Agents/administration & dosage/adverse, effects/*therapeutic use, Treatment Outcome
Postens nummer:
Posten skapad:
2008-11-17 14:55
Posten ändrad:
2012-05-08 14:33

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