The Effect of Increasing Fluence on the Treatment of Actinic Keratosis and Photodamage by Photodynamic Therapy with 5-Aminolevulinic Acid and Intense Pulsed Light

Abstract Background and objective: Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) and intense pulsed light (IPL) is a relatively new combination for the treatment of actinic keratosis (AK) and photodamage. The objective of this study was to determine the effect of increasing the fluence of IPL on the outcome of patients with these skin conditions. Methods: Patients (N = 24) were randomly assigned to five treatment treatment groups: control (IPL alone) and ALA with 20, 25, 40, and 50 J/cm2 fluence of IPL. Each patient received a single treatment. ALA was applied twice and allowed to incubate 2 h before IPL irradiation. Results were evaluated 5–7 days and 8 weeks after treatment. Clearance of AK lesions was evaluated by counting lesions before and after treatment, and improvement in photodamage was assessed by comparing pre- and post-treatment photographs. Statistical evaluation was based at nonparametric tests with a cut-off level at p < 0.10 and a confidence interval at 95%. Results: Response...