No generalized skin phototoxicity after intravesical application of 5-aminolevulinic acid for fluorescence diagnosis of superficial bladder cancer

Introduction: A prospective monocenter open study was carried out to evalua te if generalized phototoxic skin reactions occur after intravesical applic ation of 5-aminolevulinic acid (ALA) for fluorescence diagnosis of superfic ial bladder carcinomas. Patients and Methods: On 21 patients, skin phototox icity was determined prior to as well as 4, 8 and 28 h after intravesical i nstillation of a 3% ALA solution by exposing small skin areas to a progress ively graded series of defined UVA-light doses (n = 9; 5-80 J/cm(2)). Resul ts: Prior to ALA instillation, erythema or pigmentation as signs of cutaneo us phototoxicity occurred at an UVA-light dose of 28 +/- 1.5 J/cm(2) (mean +/- SEM), A reduction of the minimal phototoxic dose (MPD) was not detected 4 (28 +/- 1.9 J/cm(2)), 8 (28 +/- 1.6 J/cm(2)) and 28 h (28 +/- 1.5 J/cm(2 )) after ALA instillation. Consequently phototoxic reactions were not obser ved. Conclusions: A reduction of MPD for UVA was not detected. Therefore, i t is not necessary to protect the skin of patients from ambient or daylight after intravesical instillation of ALA for fluorescence diagnosis. Copyrig ht (C) 2000 S. Karger AG. Basel.