Photodynamic therapy of actinic keratoses with topical aminolevulinic acidhydrochloride and fluorescent blue light

Background: Aminolevulinic acid hydrochloride (ALA, Levulan) applied topica lly to actinic keratoses (AKs) leads to accumulation of the photosensitizer protoporphyrin M, which, when activated by exposure to light, eradicates A Ks. Objective: We examined the safety and efficacy of photodynamic therapy usin g topical 20% ALA in a solution formulation and varying blue light doses to treat multiple AKs on the face and scalp. Method: This is a multicenter, investigator-blinded, randomized, vehicle-co ntrolled study. Results: Thirty-six patients with clinically typical AKs were treated with 20% ALA; 14 to 18 hours later they were irradiated with a nonlaser fluoresc ent blue Light source. With the optimal light dose of 10 J/cm(2), 88% of th e AKs completely cleared 8 weeks after a single photodynamic treatment, com pared with 6% after treatment with vehicle and light. Conclusion: Topical ALA PDT using a nonlaser, blue Light source is an effec tive treatment for multiple AKs.