Vivian Lindholm, Sari Pitkänen, Marika Schröder, Sonja Hahtola, Helka Sahi, Heini Halme, Kirsi Isoherranen
DOI: 10.2340/00015555-3754

Previous research presents pulsed dye laser-mediated photodynamic therapy as a promising alternative to conventional red-light photodynamic therapy. In this study, 60 patients with 2 or more actinic keratoses randomly received either of these treatments on each side of the head. A physician blinded to the treatment evaluated treatment response at 6 months for each lesion, as completely, partially or not healed. Significantly lower complete clearance rates (10.3% vs 44.9%) and lesion-specific complete clearance rates were found for pulsed dye laser-mediated photodynamic therapy (47.9%) vs conventional red-light photodynamic therapy (73.4%). Significantly lower pain scores were found for pulsed dye laser-mediated photodynamic therapy, with a mean numerical rating of 2.3, compared with 4.1 for conventional red-light photodynamic therapy. The study population had a mean of 7.9 lesions, and 78% of patients had been treat­ed previously for actinic keratoses on the treatment area. To conclude, in a population with severe sun dam­age, pulsed dye laser-mediated photodynamic therapy seems less effective than conventional red-light photo­dynamic therapy. Pulsed dye laser-mediated photodynamic therapy may still be a treatment option for patients who are not compliant with conventional red-light photodynamic therapy.

Actinic keratoses, which are common precancerous lesions of the skin, arise from chronic lifetime sun exposure. A useful treatment method is photodynamic therapy (PDT), but this can cause strong pain during treatment. This study compared PDT using an alternative illumination source, pulsed dye laser, with conventional PDT in 60 patients with multiple actinic keratoses, in a randomized split-face design. Laser treatment seemed significantly less painful; however, in contrast to previous research, it appeared less effective than conventional PDT, with a complete clearance rate of 10% at 6 months in the laser treatment group compared with 45% in the conventional treatment group.