Low-level light-assisted photodynamic therapy using a wearable cap-like device for the treatment of actinic keratosis of the scalp

•There are many commercially available low-level light therapy (LLLT) devices that emit red light.•LLLT devices can emit at 630 nm, one of Protoporphyrin-IX wavelenghts of absortion.•Indoor photodynamic therapy with these devices are useful against actinic keratosis.•More comparative research is nec...

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Bibliographic Details
Published in:Photodiagnosis and photodynamic therapy 2019-03, Vol.25, p.136-141
Main Authors: Fonda-Pascual, Pablo, Alegre-Sánchez, Adrián, Harto-Castaño, Antonio, Moreno-Arrones, Oscar M., Pérez-García, Bibiana, González-Morales, Maria Luisa, Pindado-Ortega, Cristina, Gilaberte-Calzada, Yolanda, Aguilera, José, Jaen-Olasolo, Pedro, Fernández-Guarino, Montserrat
Format: Article
Language:English
Subjects:
Actinic keratosis
daylight PDT
Helmet
Low-level laser therapy
Methylaminolevulinate
Photodynamic therapy
Skin cancer
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Summary:•There are many commercially available low-level light therapy (LLLT) devices that emit red light.•LLLT devices can emit at 630 nm, one of Protoporphyrin-IX wavelenghts of absortion.•Indoor photodynamic therapy with these devices are useful against actinic keratosis.•More comparative research is necessary to assess its real efficacy. Daylight photodynamic therapy (dlPDT) is a painless and increasingly cost-effective treatment for actinic keratosis (AK). New protocols avoid incubation, minimizing pain and adverse events. However, it is time-consuming and dependent on specific weather conditions. In patients with AK of the scalp, we evaluated the efficacy of indoor photodynamic therapy (PDT) using a wearable low-level light therapy (LLLT) device, without pre-incubation with a photosensitizing agent. In this pilot study, 27 patients with thin and moderately thick AK (Olsen Grades I-II) underwent a single 15-minute session of LLLT using a wearable cap-like device immediately after application of methyl-aminolevulinate (MAL) cream, with no prior preparation of the affected area. Treatment efficacy was quantified by measuring the reduction in AK lesion number and the AK quality of life (AKQoL) score. All AK lesions were mapped at baseline for follow-up 2 months later. Paired pre/post scalp biopsies from 5 patients were analysed using histological and immunohistochemical techniques (p53, p27, cyclin D1, p63, and Ki67 expression). Data were analysed using the Wilcoxon signed-rank test. In all patients we observed a global reduction in the number of AK lesions (71%; p 
ISSN:1572-1000
1873-1597
DOI:10.1016/j.pdpdt.2018.11.018