Hemodynamic changes during conventional and daylight photodynamic therapy of actinic keratoses - a randomized controlled trial

J Dermatolog Treat. 2022 Nov;33(7):3022-3027. doi: 10.1080/09546634.2022.2097160. Epub 2022 Jul 8.

Abstract

Background: Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AK). However, pain and hypertension are important side effects of conventional PDT (c-PDT). Several studies have demonstrated that daylight PDT (dl-PDT) is less painful while being as effective as c-PDT.

Objective: To observe the effect of c-PDT and dl-PDT on different hemodynamic parameters (systolic blood pressure and diastolic blood pressure, pulse rate, and peripheral oxygen saturation).

Methods: Fifty patients with AK on the head were enrolled into this prospective, randomized, controlled study and treated with c-PDT or dl-PDT in a 1:1 ratio. Hemodynamic parameters were measured at four different time points during treatment. Pain was quantified using a visual analog scale. AK was counted before treatment and after one month.

Results: C-PDT is associated with significantly more pain, a significant increase in blood pressure and a higher rate of patients with grade 3 hypertension. Whereas dl-PDT is almost painless and does not lead to any changes in hemodynamic parameters. For both treatments, a similar lesion response rate was found after one month.

Conclusions: dl-PDT has a better tolerability while being as effective as c-PDT and therefore may be the more favorable treatment option in certain patient groups.

Keywords: Photodynamic therapy; blood pressure; hypertension; pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aminolevulinic Acid / therapeutic use
  • Hemodynamics
  • Humans
  • Hypertension* / drug therapy
  • Hypertension* / etiology
  • Keratosis, Actinic* / drug therapy
  • Pain / drug therapy
  • Pain / etiology
  • Photochemotherapy* / adverse effects
  • Photosensitizing Agents / therapeutic use
  • Prospective Studies
  • Treatment Outcome

Substances

  • Aminolevulinic Acid
  • Photosensitizing Agents