Photodynamic therapy activated by intense pulsed light in the treatment of actinic keratosis.

BACKGROUND: Actinic keratosis (AK), a hyperkeratotic lesion induced by solar exposure, is the precancerous lesion that most frequently develops into squamous cell carcinoma. Cryotherapy, topical fluorouracil 5, topical diclofenac 3% gel and, more recently, ingenol mebutate are used in addition to surgery. However, these treatments have varying degrees of effectiveness and are not always tolerated due to side effects. In recent years, Photodynamic Therapy (PDT), has asserted itself as a new effective and safe method for the treatment of actinic keratoses with almost no side effects. The aim of this study is to verify whether a third treatment may now be added to the "Conventional -PDT" and "Daylight-PDT": PhotoDynamic Therapy activated by Intense Pulsed Light (IPL-PDT).

METHODS: 31 patients, 24 males and 7 females, in most cases elderly, were included in the trial. As in the previous methods, also in IPL-PDT, 5-methylaminolevulinic acid (MAL) was applied topically for a period of 3 hours. Thereafter, the occlusive dressing and the topical cream, were removed and the neoformation was irradiated with IPL, with a 640nm filter with variable power. Irradiation was performed in single or multiple sessions, depending on the type of keratosis, to completely cover the lesion and the apparently healthy surrounding areas, i.e. the cancerization field.

RESULTS: Results were evaluated 3, 6 and 9 months after treatment. Treatment achieved a 95% complete clearance rate, with a 5% partial relapse 9 months after the last treatment.

CONCLUSIONS: The above method is a valid alternative to methods already in use. The results obtained demonstrate the efficacy and tolerability of the treatment described which, due to its versatility and speed of use, is preferable to the methods used so far.