Daylight photodynamic therapy - Experience and safety in treatment of actinic keratoses of the face and scalp in low latitude and high brightness region

ABSTRACT Daylight photodynamic therapy has been used in countries with high latitudes during the summer for actinic keratoses treatment with reports of similar efficacy to conventional photodynamic therapy. We evaluate its safety in 20 patients in the city of Fortaleza, a local with low latitude and high brightness. Sixteen patients did not report any discomfort due to the procedure. Daylight photodynamic therapy is an easy application method with great tolerability by the patient and has the possibility of being performed throughout the year in these regions. It can mean a promising tool in the control of skin cancer.

Terapia fotodinâmica com luz do dia: farmacoeconomia no uso do creme de metilaminolevulinato para ceratoses actínicas faciais / Daylight photodynamic therapy: pharmacoeconomics of methyl aminolevulinate cream use for facial actinic keratoses

Introdução: As ceratoses actínicas são as lesões pré-malignas de pele mais comuns, apresentando caráter crônico e recorrente. A terapia fotodinâmica com luz do dia tem sido utilizada no tratamento de ceratoses actínicas de face e couro cabeludo. Objetivo: Demonstrar a possibilidade da realização da terapia fotodinâmica com luz do dia em serviço público para o tratamento de ceratoses actínicas em face, utilizando um tubo de creme de metilaminolevulinato em até quatro pacientes. Métodos: Foram selecionados 10 pacientes para a realização de terapia fotodinâmica com luz do dia, realizando-se curetagem das ceratoses actínicas seguidas da aplicação de filtro químico e creme de metilaminolevulinato em toda a face. Resultados: um tubo de creme de metilaminolevulinato, foi suficiente para tratar até quatro pacientes com múltiplas ceratoses actínicas de face, enquanto os estudos sugerem o uso de pelo menos 1g para tratar uma face completa. Conclusões: O resultado nos leva a afirmar que na terapia fotodinâmica com luz do dia, a utilização de quantidade inferior a 1 grama de creme de metilaminolevulinato no tratamento de ceratoses actínicas de face é posologia factível para obtenção de efetiva resposta clínica.

Introduction: Actinic keratoses are the most common premalignant skin lesions, with a chronic and recurrent nature. Daylight photodynamic therapy has been used in the treatment of actinic keratoses of the face and scalp. Objective: To demonstrate the possibility of implementing daylight photodynamic therapy at a public service, for the treatment of facial actinic keratosis, using one tube of methyl aminolevulinate cream for up to four patients. Methods: Ten patients were selected to undergo daylight photodynamic therapy at the Centro de Dermatologia Dona Libânia, located in the city of Fortaleza (CE), Brazil. Curettage was performed on the actinic keratosis and a methyl aminolevulinate cream based chemical filter was applied across the face. Results: One tube of methyl aminolevulinate cream was enough for treating up to four patients with multiple facial actinic keratoses, whereas studies suggest the use of at least one gram to treat one face completely. Conclusion: It was possible to conclude when administering daylight photodynamic therapy, an amount of less than one gram of methyl aminolevulinate cream in the treatment of facial actinic keratoses is a dosage sufficient to obtain an effective clinical response.