Ablative Fractional Laser-assisted Low-irradiance Photodynamic Therapy for Treatment of Actinic Keratoses in Organ Transplant Recipients: A Prospective, Randomized, Intraindividual Controlled Trial

Authors

  • Anke S. Lonsdorf Department of Dermatology, University Hospital Heidelberg, Germany
  • Aric Keller Department of Dermatology, University Hospital Heidelberg, Germany
  • Julia Hartmann
  • Alexander H. Enk Department of Dermatology, University Hospital Heidelberg, Germany
  • Patrick Gholam Department of Dermatology, University Hospital Heidelberg, Germany

DOI:

https://doi.org/10.2340/actadv.v102.1057

Keywords:

actinic keratosis, keratinocyte cancer, organ transplant recipients, photodynamic therapy, immunosuppression

Abstract

Pain and inferior efficacy are major limiting factors of conventional photodynamic therapy for the field treatment of actinic keratoses in immunosuppressed organ transplant recipients. This prospective randomized controlled study evaluates the efficacy and tolerability of ablative fractional laser system pretreatment combined with low-irradiance photodynamic therapy (18.5 mW/cm2) compared with conventional photodynamic therapy (61.67 mW/cm2) in the treatment of actinic keratoses on the face and scalp in organ transplant recipients, using a red light-emitting diode lamp at a total light dose of 37 J/cm2. Low-irradiance photodynamic therapy combined with Er:YAG pretreatment achieved a significantly superior lesion response rate (mean ± standard deviation 77.3 ± 23.6%) compared with conventional photodynamic therapy (61.8 ± 21.4%; p = 0.025) in intra-individual fields at 3 months without negatively impacting pain (p = 0.777) or cosmetic outcome (p = 0.157).

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Author Biographies

Anke S. Lonsdorf, Department of Dermatology, University Hospital Heidelberg, Germany

Senior Consulting Physician, Department of Dermatology, University Hospital Heidelberg, Germany

Alexander H. Enk, Department of Dermatology, University Hospital Heidelberg, Germany

Professor and Chairman of the Department of Dermatology, University Hospital Heidelberg, Germany

Patrick Gholam, Department of Dermatology, University Hospital Heidelberg, Germany

Senior Consulting Physician, Department of Dermatology, University Hospital Heidelberg, Germany

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Published

2022-04-13

How to Cite

Lonsdorf, A. S., Keller, A., Hartmann, J., Enk, A. H., & Gholam, P. . (2022). Ablative Fractional Laser-assisted Low-irradiance Photodynamic Therapy for Treatment of Actinic Keratoses in Organ Transplant Recipients: A Prospective, Randomized, Intraindividual Controlled Trial. Acta Dermato-Venereologica, 102, adv00694. https://doi.org/10.2340/actadv.v102.1057