This article is more than 5 years old. Information may no longer be current.

Artificial white light as effective as daylight photodynamic therapy for actinic keratosis

Artificial white light photodynamic therapy was as effective and tolerated as daylight photodynamic therapy in men with actinic keratosis, according to study results recently published in JAMA Dermatology.

“Significant photo damage and [actinic keratosis], also called field cancerizations, is common, particularly in elderly bald men with increased risk of squamous cell carcinoma,” the researchers wrote.

The researchers conducted a prospective, randomized, single-blind study of 22 men (median age, 72 years) with a high number of actinic keratoses (AKs), and compared the effectiveness and adverse effects of daylight photodynamic therapy (PDT) and artificial white light PDT for treating forehead and scalp AKs, using a split-scalp design.

Patients were treated between April and July 2014, with follow-up at 9 months after treatment.

The scalp was treated for nine patients, treatment fields overlapped the scalp and forehead for12 patients, and one patient had the forehead dominating treatment.

The daylight PDT treatment area had 469 AKs (median of AKs per field, 20.5), while the artificial white light PDT treatment area had 496 (median of AKs per field, 20.5).

At 1 month, the median number of AKs per field reduced by 12 for daylight PDT, a 62.3% reduction (P = .21). For artificial white light PDT, the median number of AKs per field reduced by 14, a 67.7% reduction (P = .13).

The two treatments did not show a significant difference at 1, 3 and 6 months in reduction percentage of AKs. At 9 months, daylight PDT treatment resulted in a median number and percentage of reduction in AKs per field of 9 and 48.4%, compared with 12 and 64.4% for artificial white light PDT (P = .13 and P = .05, respectively).

Fourteen patients treated with daylight PDT and 16 patients with artificial white light PDT reported pain, while moderate erythema was reported by nine patients after daylight PDT treatment and 14 patients following artificial white light PDT treatment.

Patients rated both highly, with 9 and 9.5 on a 10-point scale for tolerability for daylight PDT and artificial white light PDT, respectively.

“Daylight and [artificial white light] PDT are important advances for the growing population of patients with field cancerization who cannot tolerate [conventional] PDT,” the researchers concluded. “Artificial white light PDT in this study was effective and offered a more sustained remission at 9 months in a cohort with significant field cancerization; it can also be used a  suitable pain-free alternative to [conventional] PDT and [daylight] PDT all year if required.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.