Efficacy of ALA-PDT vs blue light in the treatment of acne
Efficacy of ALA-PDT vs blue light in the treatment of acne
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DOI：
10.1111/j.1600-0781.2007.00303.x
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发表时间：
2007-10-01
影响因子：
2.6
通讯作者：
Gritiyarangsan, P.
中科院分区：
文献类型：
--
作者：
Akaraphanth, R.;Kanjanawanitchkul, W.;Gritiyarangsan, P.
光动力疗法(PDT)是基于利用波长特异性的内源性或外源性光敏剂的光激发来破坏靶组织的原理，已在某些非黑色素瘤皮肤癌的治疗中显示出疗效。采用氨基酮戊酸(5-ALA)的光动力疗法治疗寻常痤疮已引起人们的重视。20例面部中重度寻常痤疮患者接受了4次局部ALA-PDT治疗，其中右侧用蓝光(415 Nm)，左侧只用蓝光，每次治疗间隔1周。将10%的ALA局部涂在面部右侧的痤疮斑点上，潜伏期为1h，整个面部接受48J/cm(2)415+/-5 nm的关节LED平面阵列光治疗。通过在基线、治疗开始后4、8、12和16周计算痤疮皮损来进行评估。在治疗开始后的4、8、12和16周，ALA-PDT区炎症皮损计数的平均减少百分比趋于较高，分别为32%、50.9%、65.9%和71.1%，而单纯蓝光治疗组分别为20.7%、27%、57.7%和56.7%，但无统计学意义(P=0.092)。治疗后皮脂排泄量、红斑及黑色素指数均无明显变化。副作用为疼痛、刺痛、脱皮、红斑、瘙痒、渗出和脓疱疹。这些副作用在ALA-PDT治疗侧更强。从这项研究中，观察到ALA-PDT联合蓝光治疗优于单独使用蓝光治疗的趋势，但没有达到统计学意义。ALA-PDT副作用较多。
Photodynamic therapy (PDT) is based on the principle of using light excitation of a wavelength-specific endogenous or exogenous photosensitizer to destroy the target tissue, and has shown efficacy in the treatment of certain non-melanoma skin cancers. PDT using aminolevulinic acid (5-ALA) has attracted attention in the treatment of acne vulgaris.Twenty patients with moderate to severe acne vulgaris on the face were treated with four sessions of topical ALA-PDT with blue light (415 nm) on the right side of the face compared with blue light alone on the left side of the face, each treatment being 1 week apart. Ten percent of topical ALA was applied to acne spots on the right side of the face with a 1-h incubation period and the entire face was treated with 48 J/cm(2) of 415 +/- 5 nm light from an articulated LED planar array. Evaluation was performed by counting acne lesions at baseline, 4, 8, 12 and 16 weeks after the beginning of the treatment. Biophysical measurements included sebum levels and the erythema, and melanin indices.At the given assessment times 4, 8, 12 and 16 weeks after the beginning of the treatment, the mean percent reduction in inflamed lesions counts tended to be higher in the ALA-PDT areas; it was 32%, 50.9%, 65.9% and 71.1%, respectively, compared with the blue-light-alone treatment, which was 20.7%, 27%, 57.7% and 56.7%, respectively, but without any statistical significance (P=0.092). There was no demonstrable significant change in sebum excretion, erythema or the melanin index after treatment. The side effects were pain, stinging, peeling, erythema, pruritus, oozing and pustules. These side effects were stronger on the ALA-PDT-treated side.From this study, the trend for ALA-PDT with blue light to be superior to blue light alone was observed, but it did not reach statistical significance. ALA-PDT had more side effects.