ABSTRACT
Actinic keratosis (AK), also known as solar keratosis or pre-cancerous keratosis, is frequently observed in areas of skin exposed to sunlight, particularly in light-skinned patients. In France, photodynamic therapy using red light (conventional PDT) and methylamino 5-levulinate (MAL) is indicated in the treatment of thin or non-hyperkeratotic and non-pigmented multiple AK lesions or large zones covered with AK lesions. It is well-known for its efficacy but also for its side effects, especially pain during illumination, which can limit its use. An alternative to PDT using natural daylight has recently been proposed to treat actinic keratosis lesions, and results in greater flexibility as well as significant reduction in pain. The lesions are prepared as for conventional PDT, with MAL cream being applied by the physician or the patient, after which they are exposed to natural daylight for 2hours. The lesions are then gently cleansed and protected from natural light for 24hours. This paper seeks to provide a precise description of the daylight PDT procedure for the treatment of AK.
Subject(s)
Aminolevulinic Acid/analogs & derivatives , Keratosis, Actinic/drug therapy , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Sunlight , Aminolevulinic Acid/administration & dosage , Aminolevulinic Acid/therapeutic use , Clinical Protocols , Facial Dermatoses/drug therapy , Humans , Pain/etiology , Pain/prevention & control , Patient Education as Topic , Photochemotherapy/adverse effects , Photosensitizing Agents/administration & dosage , Scalp Dermatoses/drug therapy , Skin Cream , Treatment OutcomeABSTRACT
One hundred and one female patients with vulvar condylomata acuminata were treated with the argon laser. Most were managed under regional or general anesthesia because of the large size and extent of the warts. Ten patients were lost to follow-up after the first session. Of 91 other patients, 78 (86%) were free of lesions on follow-up examinations after one or two treatments. The 13 other patients had recurrent lesions: seven patients underwent three laser sessions; four required four sessions, and 2 others required five and six sessions, respectively. These results were comparable with those achieved with the carbon dioxide laser.
