Photodynamic therapy (PDT) with topical methyl aminolevulinate (MAL) administered in two treatment sessions separated by 1 week is an effective treatment for actinic keratoses. This open prospective study compared the...Photodynamic therapy (PDT) with topical methyl aminolevulinate (MAL) administered in two treatment sessions separated by 1 week is an effective treatment for actinic keratoses. This open prospective study compared the efficacy and safety of MAL- PDT given as a single treatment with two treatments of MAL- PDT 1 week apart. Two hundred and eleven patients with 413 thin to moderately thick actinic keratoses were randomized to either a single treatment with PDT using topical MAL (regimen I; n=105) or two treatments 1 week apart (regimen II; n=106). Each treatment involved surface debridement, application of Metvix(r) cream (160 mg/g) for 3 h, followed by illumination with red light using a light- emitting diode system (peak wave length 634± 3 nm, light dose 37 J/cm2). Thirtyseven lesions (19% ) with a non- complete response 3 months after a single treatment were re- treated. All patients were followed up 3 months after the last treatment. A total of 400 lesions, 198 initially treated once and 202 treated twice, were evaluable. Complete response rate for thin lesions after a single treatment was 93% (95% CI=87- 97% ), which was similar to 89% (82- 96% ) after repeated treatment. Response rates were lower after single treatment of thicker lesions (70% (60- 78% )- vs 84% (77- 91% )), but improved after repeated treatment (88% (82- 94% )). The conclusion of this study is 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.展开更多
The naevus profile was examined in a Swedish cohort of 8-9-year-old children; 524/545 individuals (96%) were examined (279 boys and 245 girls). There was a wide variation in the total number of naevi (0-79) and boys h...The naevus profile was examined in a Swedish cohort of 8-9-year-old children; 524/545 individuals (96%) were examined (279 boys and 245 girls). There was a wide variation in the total number of naevi (0-79) and boys had more naevi than girls (median 9 and 7, respectively, P < 0.01). No dysplastic naevi were found. Overall, 15/524 (3%) had at least one lesion clinically diagnosed as a congenital melanocytic naevus. Boys hadmore naevi on the face (median 1) and trunk (median 5) than girls (median 0 and 3, respectively, P < 0.001). There was no difference in the number of naevi on the legs between the two sexes. The highest counts per unit surface area for both sexes were found on the back, chest and the lateral aspect of the arms, areas intermittently sun-exposed. Children with fair skin and light eye colours had significantly more naevi than those with darker colours but children with red hair had very few naevi. Children with one or more naevi on the buttocks (25%), dorsal surfaces of the feet (11%) or on the scalp (7%) had twice as many naevi in total compared with those without naevi in these regions. Children with naevi in all three regions (0.8%) had four times as many naevi in total. A relationship between total counts and counts on the back or lateral aspect of the arms was found (r2=0.59). Either of these two areas might be suitable for predicting total naevus counts.展开更多
文摘Photodynamic therapy (PDT) with topical methyl aminolevulinate (MAL) administered in two treatment sessions separated by 1 week is an effective treatment for actinic keratoses. This open prospective study compared the efficacy and safety of MAL- PDT given as a single treatment with two treatments of MAL- PDT 1 week apart. Two hundred and eleven patients with 413 thin to moderately thick actinic keratoses were randomized to either a single treatment with PDT using topical MAL (regimen I; n=105) or two treatments 1 week apart (regimen II; n=106). Each treatment involved surface debridement, application of Metvix(r) cream (160 mg/g) for 3 h, followed by illumination with red light using a light- emitting diode system (peak wave length 634± 3 nm, light dose 37 J/cm2). Thirtyseven lesions (19% ) with a non- complete response 3 months after a single treatment were re- treated. All patients were followed up 3 months after the last treatment. A total of 400 lesions, 198 initially treated once and 202 treated twice, were evaluable. Complete response rate for thin lesions after a single treatment was 93% (95% CI=87- 97% ), which was similar to 89% (82- 96% ) after repeated treatment. Response rates were lower after single treatment of thicker lesions (70% (60- 78% )- vs 84% (77- 91% )), but improved after repeated treatment (88% (82- 94% )). The conclusion of this study is 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.
文摘The naevus profile was examined in a Swedish cohort of 8-9-year-old children; 524/545 individuals (96%) were examined (279 boys and 245 girls). There was a wide variation in the total number of naevi (0-79) and boys had more naevi than girls (median 9 and 7, respectively, P < 0.01). No dysplastic naevi were found. Overall, 15/524 (3%) had at least one lesion clinically diagnosed as a congenital melanocytic naevus. Boys hadmore naevi on the face (median 1) and trunk (median 5) than girls (median 0 and 3, respectively, P < 0.001). There was no difference in the number of naevi on the legs between the two sexes. The highest counts per unit surface area for both sexes were found on the back, chest and the lateral aspect of the arms, areas intermittently sun-exposed. Children with fair skin and light eye colours had significantly more naevi than those with darker colours but children with red hair had very few naevi. Children with one or more naevi on the buttocks (25%), dorsal surfaces of the feet (11%) or on the scalp (7%) had twice as many naevi in total compared with those without naevi in these regions. Children with naevi in all three regions (0.8%) had four times as many naevi in total. A relationship between total counts and counts on the back or lateral aspect of the arms was found (r2=0.59). Either of these two areas might be suitable for predicting total naevus counts.
