Methyl 5-aminolaevulinic Acid 국소 광역동 요법을 이용한 광선각화증의 치료 (Topical Photodynamic Therapy with Methyl-aminolevulinic Acid for the Treatment of Actinic Keratosis)

서지정보

· 발행기관 : 대한피부과학회
· 수록지 정보 : 대한피부과학회지 / 48권 / 10호 / 837 ~ 843페이지
· 저자명 : 박현선, 진선필, 조광현

초록

Background: Photodynamic therapy (PDT) is a treatment modality involving the use of a photosensitizer, oxygen and a light source to induce selective targeted cell death. It is used for various skin conditions, including actinic keratosis (AK). Both 5-aminolevulinic acid and methyl aminolevulinic acid (MAL) are currently available as photosensitizers. Although there are several studies on the treatment of AK using 5-aminolevulinic acid-PDT in Korea, there are few studies on using MAL-PDT for the treatment of AK.
Objective: The purpose of this study is to evaluate the efficacy and safety of MAL-PDT for the treatment of AK.
Methods: We performed a retrospective study and reviewed 64 AK lesions from 28 patients who were treated by MAL-PDT between January 2008 and April 2010. The data was collected through the medical records, the clinical photographs and the biopsy specimens.
Results: The patients were treated with either a single treatment or double treatments 1 week apart. The treatment results were assessed after 12 weeks. Overall, complete remission was achieved in 42/64 lesions (65.6%). Although a single treatment was effective for thin lesions, the complete response rates were significantly lower for the moderately thick and severely thick lesions (100% vs 71.3% vs 22.2%, respectively). Repeated treatment tended to improve the complete response rate of the severely thick lesions. A favorable cosmetic outcome was achieved and only tolerable local side effects were reported after MAL-PDT. The patients were followed up for an average period of 6 months and 4 lesions recurred.
Conclusion: MAL-PDT is an effective and well-tolerated treatment option for thin and moderately thick AK.
However, further study is required for determining the optimal regimen for thicker lesions and the long-term treatment results of MAL-PDT.

영어초록

Background: Photodynamic therapy (PDT) is a treatment modality involving the use of a photosensitizer, oxygen and a light source to induce selective targeted cell death. It is used for various skin conditions, including actinic keratosis (AK). Both 5-aminolevulinic acid and methyl aminolevulinic acid (MAL) are currently available as photosensitizers. Although there are several studies on the treatment of AK using 5-aminolevulinic acid-PDT in Korea, there are few studies on using MAL-PDT for the treatment of AK.
Objective: The purpose of this study is to evaluate the efficacy and safety of MAL-PDT for the treatment of AK.
Methods: We performed a retrospective study and reviewed 64 AK lesions from 28 patients who were treated by MAL-PDT between January 2008 and April 2010. The data was collected through the medical records, the clinical photographs and the biopsy specimens.
Results: The patients were treated with either a single treatment or double treatments 1 week apart. The treatment results were assessed after 12 weeks. Overall, complete remission was achieved in 42/64 lesions (65.6%). Although a single treatment was effective for thin lesions, the complete response rates were significantly lower for the moderately thick and severely thick lesions (100% vs 71.3% vs 22.2%, respectively). Repeated treatment tended to improve the complete response rate of the severely thick lesions. A favorable cosmetic outcome was achieved and only tolerable local side effects were reported after MAL-PDT. The patients were followed up for an average period of 6 months and 4 lesions recurred.
Conclusion: MAL-PDT is an effective and well-tolerated treatment option for thin and moderately thick AK.
However, further study is required for determining the optimal regimen for thicker lesions and the long-term treatment results of MAL-PDT.

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