Multicentre intraindividual randomized trial of topical methyl aminolaevulinate–photodynamic therapy vs. cryotherapy for multiple actinic keratoses on the extremities

@article{Kaufmann2008MulticentreIR,
  title={Multicentre intraindividual randomized trial of topical methyl aminolaevulinate–photodynamic therapy vs. cryotherapy for multiple actinic keratoses on the extremities},
  author={Roland Prof. Dr. Kaufmann and Lynda Spelman and Warren Weightman and Julia Reifenberger and R M Szeimies and Evelien Verhaeghe and Nabil Kerrouche and Val{\'e}rie Sorba and Herv{\'e} Villemagne and Lesley E Rhodes},
  journal={British Journal of Dermatology},
  year={2008},
  volume={158}
}
Background Methyl aminolaevulinate–photodynamic therapy (MAL‐PDT) is an effective treatment in facial/scalp actinic keratosis (AK). 
Intraindividual, right–left comparison of topical 5‐aminolevulinic acid photodynamic therapy vs. 5% imiquimod cream for actinic keratoses on the upper extremities
Backround  Actinic keratoses (AKs) are considered as in situ squamous cell carcinoma. Early and effective treatment is important.
A randomized clinical trial of photodynamic therapy with methyl aminolaevulinate vs. diclofenac 3% plus hyaluronic acid gel for the treatment of multiple actinic keratoses of the face and scalp
A gel containing diclofenac and hyaluronic acid (DHA) and photodynamic therapy with methyl aminolaevulinate (MAL‐PDT) are widely used treatments for actinic keratoses (AKs).
Topical treatment of actinic keratoses with low‐dose 5‐fluorouracil in combination with salicylic acid – pilot study
  • M. Schlaak, J. Simon
  • Medicine
    Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
  • 2010
TLDR
Treatment of actinic keratoses can be achieved by physical ablation, chemotherapeutic agents, immunomodulators or photodynamic therapy and can progress to invasive squamous cell carcinomas.
Comparative study of imiquimod 3.75% vs. photodynamic therapy for actinic keratosis of the scalp
TLDR
Both imiquimod and MAL-PDT were effective in the reduction in the number of AK and in the long-term, both present a good effectiveness maintained over time with excellent aesthetic results.
Cryotherapy is preferable to ablative CO2 laser for the treatment of isolated actinic keratoses of the face and scalp: a randomized clinical trial
TLDR
Actinic keratosis (AK) may progress to squamous cell carcinoma, and lesion‐directed treatments are considered valuable options despite poor published evidence of their therapeutic activity.
A randomized comparative study of tolerance and satisfaction in the treatment of actinic keratosis of the face and scalp between 5% imiquimod cream and photodynamic therapy with methyl aminolaevulinate
TLDR
This data indicates that conventional photodynamic therapy and imiquimod are two excellent treatments for actinic keratosis but are often not well tolerated by patients.
Photodynamic therapy using intense pulsed light for treating actinic keratoses and photoaged skin of the dorsal hands: a randomized placebo‐controlled study
TLDR
The efficacy of photodynamic therapy with intense pulsed light with IPL for treating actinic keratoses and improving photoaged skin on the face but not yet on the dorsal hands is shown.
Comparison of protoporphyrin IX accumulation and destruction during methylaminolevulinate photodynamic therapy of skin tumours located at acral and nonacral sites
Background  Topical photodynamic therapy (PDT) is successful in the treatment of nonmelanoma skin cancers and associated precancers, but efficacy is significantly reduced in actinic keratosis lesions
Cryosurgery combined with topical interventions for actinic keratosis: a systematic review and meta‐analysis
Actinic keratoses (AKs) are early in situ carcinomas of the skin caused by cumulative sun exposure. Cryosurgery is an easy and practicable lesion‐directed approach for treatment of isolated lesions.
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References

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Intraindividual, right–left comparison of topical methyl aminolaevulinate‐photodynamic therapy and cryotherapy in subjects with actinic keratoses: a multicentre, randomized controlled study
TLDR
Treatment should not only be effective, but also well tolerated and allow for good cosmesis on typical sun‐exposed highly visible body sites.
Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study.
TLDR
Investigation of the complete response rates, cosmetic outcome, and patient satisfaction after photodynamic therapy (PDT) using methyl 5-aminolevulinate versus cryotherapy in the treatment of AK found PDT giving better cosmetic results and higher patient satisfaction than cryotherapy.
Photodynamic therapy with topical methyl aminolevulinate for actinic keratosis: results of a prospective randomized multicenter trial.
TLDR
In this small study, PDT using topical MAL was a safe and effective treatment for actinic keratoses with excellent cosmetic outcome and is a promising treatment that could benefit from further study.
A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix®) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study
TLDR
P PDT with methyl aminolevulinate is an excellent treatment option, particularly for patients with widespread damage or AK lesions in cosmetically sensitive areas, and statistically significantly better than both cryotherapy and placebo PDT in terms of response rates and cosmetic outcome.
Photodynamic therapy with topical application of 5-aminolevulinic acid in the treatment of actinic keratoses: an initial clinical study.
TLDR
This study demonstrated the potential of good efficacy and tolerability in the treatment of AK using topical ALA-PDT and how efficacy for lesions on the hand can be improved and whether PDT is able to concur with established treatment modalities remains to be shown in further studies.
A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate (Metvix)-PDT in actinic keratosis of the face and scalp.
TLDR
It is concluded that single treatment with topical MAL-PDT is effective for thin actinic keratosis lesions; however, repeated treatment is recommended for thicker or non-responding lesions.
Cryosurgery cure rate of actinic keratoses.
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