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首页> 外文期刊>Photodiagnosis and Photodynamic Therapy >Topical tacalcitol as neoadjuvant for photodynamic therapy of acral actinic keratoses: An intra-patient randomized study
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Topical tacalcitol as neoadjuvant for photodynamic therapy of acral actinic keratoses: An intra-patient randomized study

机译：术语术语丙烯动力学疗法作为新辅助术治疗的局部左甲酸：患有患者内部的随机研究

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Background: photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) is a well described and widely practiced treatment for actinic keratoses (AKs) on the head and face. Less is known about its use for AKs on upper extremities, which can be challenging for the dermatologist. The aim of our study was to compare the combination of topical tacalcitol before 5-ALA-PDT vs conventional 5-ALA-PDT for acral AKs in a prospective, randomized, infra-individual clinical study.Methods: patients with AKs of both upper extremities underwent keratolytic pretreatment with topical tacalcitol on the back of one hand and/or forearm (right vs left), randomly selected, for fifteen consecutive days before PDT. All patients underwent one session of 5-ALA-PDT. Visual analog scale for pain was assessed immediately after PDT session and any side effects were recorded after 3 days. Efficacy was evaluated with lesion count (LC) prior to treatment (V0) and 90 days (V1) after PDT.Results: twenty-one patients with multiple acral AKs were enrolled and completed the study. At V1, neoadjuvant combination of topical tacalcitol plus PDT was significantly more effective than PDT alone (percentage reduction in total lesion count was 44.4 %. There was no significant difference in VAS pain score between the two treatment modalities. Mild erythema was the only local side effect reported for both treatment regimens (52.4 %, tacalcitol plus PDT vs 42.9 %, PDT alone).Conclusions: neoadjuvant use of topical tacalcitol might be useful to improve PDT efficacy, especially in hard-to-treat AKs on extremities.
机译：背景：具有局部5-氨基乙酰丙酸（ALA）的光动力疗法（PDT）是对头部和面部的光化角膜（AKS）的良好描述的和广泛实践的处理。较少是已知其用于上肢上的AKS的用途，这可能对皮肤科医生有挑战性。我们的研究目的是在前瞻性，随机的，内部临床研究中比较5 - Ala-PDT与常规5-Ala-PDT的常规5-Ala-PDT之前的局部甲酰丙酮醇的组合。方法：上肢AKS的患者经历角溶液预处理，用一只手的背面和/或前臂（右侧左），随机选择，在PDT之前连续十五天（右侧VS左）。所有患者均接受了一个5 Ala-PDT的一次会议。在PDT会议后立即评估疼痛的视觉模拟规模，3天后记录任何副作用。在治疗（v0）和90天（v1）之前用病变计数（LC）评估疗效评估疗效：结果：二十一名患有多个患有多种患者的AKS患者进行招募并完成研究。在v1，局部替代醇加上PDT的新辅助组合比单独的PDT更有效（总病变计数的百分比为44.4％。两种治疗方式之间的VAS疼痛评分没有显着差异。温和的红斑是唯一的本地方面据报道，治疗方案报告（52.4％，甲酰碱加上PDT与42.9％，单独PDT）。结论：Neoadjuvant使用局部甲酰基丙酸可能有助于提高PDT疗效，特别是在四肢难以治疗的AKS中。

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