טיפול פוטודינמי באמצעות אור יום מול טיפול פוטודינמי קונבציונלי לטיפול באקנה וולגריס

Background

Acne vulgaris typically affects about 85% of adolescents, and often continues into adulthood. PDT has emerged as a possible treatment modality. However, pain during illumination and subsequent swelling, redness and erosions limit the usage of this treatment modality.

Objective

We aimed at comparing the therapeutic efficacy of DL-PDT vs. C-PDT in acne vulgaris.

Methods

We conducted a prospective, intra-patient comparative study, treating one side of the face with DL-PDT and the other with C-PDT. Fifteen participants with moderate to severe facial acne received 4 treatment sessions at a 3 weeks-interval. ALA was applied to both sides of the face. One side was covered with a light-impermeable dressing, after which they spent 2 hours outdoors. The previously covered side of the face was later illuminated with red light (630 nm) from a non-coherent light source (Aktilite, Galderma) at a dose of 75 J/cm2. Efficacy was assessed using the Global Acne Severity Scale (GASS) and inflammatory acne lesion counts against baseline at each treatment session and at the follow-up 3 months after last treatment. Tolerance and adverse effects on each side were recorded.

Results

Fourteen patients completed the study. Significant similar improvement in GASS scores was seen on both sides of the face in 80% of the patients, with a reduction of at least two grades in GASS in 46% of patients at the follow-up session. Treatment with DL-PDT was much better tolerated, with no pain reported during the sun exposure, and decreased adverse events afterwards (edema, erythema, pustules, crusts, exfoliation).

Conclusions

DL-PDT is not inferior to C-PDT for the treatment of inflammatory acne vulgaris, with a superior tolerance and side-effect profile.