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

Where Ebola battles are won

7 hours ago

(HealthDay)—Four hospitals that are home to advanced biocontainment facilities have become America's ground zero in the treatment of Ebola patients.

Depression tied to worse lumbar spine surgery outcomes

9 hours ago

(HealthDay)—Depressive symptoms are associated with poorer long-term outcome in patients undergoing surgery for lumbar spinal stenosis (LSS), according to research published in the Oct. 1 issue of The Sp ...

Ebola death toll edging to 4,900 mark: WHO

10 hours ago

The death toll in the world's worst-ever Ebola outbreak has edged closer to 4,900, while almost 10,000 people have now been infected, new figures from the World Health Organization showed Wednesday.

US to track everyone coming from Ebola nations

10 hours ago

U.S. authorities said Wednesday that everyone traveling into the U.S. from Ebola-stricken nations will be monitored for symptoms for 21 days. That includes returning American aid workers, federal health employees ...

User comments