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Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study
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2008 (English)In: Transplantation, ISSN 0041-1337, Vol. 86, no 3, 423-9 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Organ transplant recipients on long-term immunosuppressive therapy are at increased risk of non-melanoma skin lesions. Repeated field photodynamic therapy using topical methyl aminolevulinate (MAL) may have potential as a preventive treatment. METHODS: This open randomized, intrapatient, comparative, multicenter study included 81 transplant recipients with 889 lesions (90% actinic keratoses (AK)]. In each patient, the study treatment was initially administered to one 50 cm area on the face, scalp, neck, trunk, or extremities (n=476 lesions) twice (1 week apart), with additional single treatments at 3, 9, and 15 months. On each occasion, the area was debrided gently and MAL cream (160 mg/g) applied for 3 hr, before illumination with noncoherent red light (630 nm, 37 J/cm2). The control, 50 cm2 area (n=413 lesions) received lesion-specific treatment (83% cryotherapy) at baseline and 3, 9, and 15 months. Additionally, all visible lesions were given lesion-specific treatment 21 and 27 months in both treatment and control areas. RESULTS: At 3 months, MAL photodynamic therapy significantly reduced the occurrence of new lesions (65 vs. 103 lesions in the control area; P=0.01), mainly AK (46% reduction; 43 vs. 80; P=0.006). This effect was not significant at 27 months (253 vs. 312; P=0.06). Hypopigmentation, as assessed by the investigator, was less evident in the treatment than control areas (16% vs. 51% of patients; P<0.001) at 27 months. CONCLUSION: Our results suggest that repeated field photodynamic therapy using topical MAL may prevent new AK in transplant recipients although further studies are needed.

Place, publisher, year, edition, pages
2008. Vol. 86, no 3, 423-9 p.
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Medical and Health Sciences
URN: urn:nbn:se:uu:diva-104683DOI: 10.1097/TP.0b013e318180731eISI: 000258482500009PubMedID: 18698246OAI: oai:DiVA.org:uu-104683DiVA: diva2:220047
Available from: 2009-05-29 Created: 2009-05-29 Last updated: 2009-06-02Bibliographically approved

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