Photodynamic therapy vs. cryotherapy for actinic keratoses

Photodynamic therapy (PDT, which uses topical agents and light to kill tissue) appears to better clear actinic keratoses (AKs, a common skin lesion caused by sun damage) at three months after treatment than cryotherapy (which uses liquid nitrogen to freeze lesions).

AKs are rough, scaly on the skin typically found on individuals with fair complexions who have had lots of sun exposure. The lesions have the potential to become cancer. PDT is an increasingly popular treatment.

The authors compared PDT with cryotherapy in a meta-analysis of four studies that included 641 patients with a total of 2,174 AKs treated with cryotherapy and 2,170 lesions treated with PDT.

Patients treated with PDT had a 14 percent better chance of complete lesion clearance at three months after treatment than cryotherapy for thin AKs on the face and scalp.

"An analysis of the effectiveness of PDT compared with other treatments may help physicians decide what role it should play in their own clinical practice." Gayatri Patel, M.D., M.P.H., of the University of California Davis Medical Center, in Sacramento, and colleagues said in their JAMA Dermatology article.

In a related editorial, Harvey Lui, M.D., F.R.C.P.C., of the University of British Columbia, writes: "Notwithstanding the apparent superiority of PDT to cryotherapy, the light-based approach to treating AK has three major limitations. The current financial remuneration model is a major disincentive. … Although PDT appears to be a simple concept, in practice optimal results may require longer drug incubation times and perhaps light-dose fractionation to generate a sufficient tissue effect. … Finally, local pain owing to photosensitizer activation during light exposure is perhaps the most striking adverse effect that clinicians need to anticipate and manage during PDT."

"All three of these limiting factors necessitate added time and resources compared with the relatively brief outpatient visits for , in which is simply and efficiently dispensed to the skin," Lui notes.

More information: JAMA Dermatology. Published online August 27, 2014. DOI: 10.1001/jamadermatol.2014.1253
JAMA Dermatology. Published online August 27, 2014. DOI: 10.1001/jamadermatol.2014.1869

add to favorites email to friend print save as pdf

Related Stories

Biochips for better cancer therapy

Feb 25, 2014

Cancer is the second leading cause of disease-related death in the United States, and may overtake heart disease without aggressive new therapies. One promising area of cancer treatment is photodynamic therapy ...

Recommended for you

Evidence-based recs issued for systemic care in psoriasis

17 hours ago

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

18 hours ago

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

18 hours ago

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

Discovery of genes that predispose a severe form of COPD

21 hours ago

A study by Ramcés Falfán-Valencia, researcher at the National Institute of Respiratory Diseases (INER), found that the mestizo Mexican population has a number of variations in certain genes that predispose ...

On the environmental trail of food pathogens

22 hours ago

Tracking one of the deadliest food contamination organisms through produce farms and natural environments alike, Cornell microbiologists are showing how to use big datasets to predict where the next outbreak could start.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.