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18. Treatment of keloids with photodynamic therapy using
5-aminolevulinic acid (5-ALA-PDT): a preliminary study
Mamiko Tosa1, Masahiro Murakami1, Itaru Iwakiri1, Hiroki Umezawa1, Hiko
Hyakusoku2
1:Department of Plastic and Reconsrtructive Surgery, Nippon Medical
school Musashikosugi Hospital, Kawasaki, Japan
2:Department of Plastic and Reconstructive Surgery, Nippon Medical
School, Tokyo, Japan
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Numerous treatment modalities have been used to treat keloids, but the
optimal treatment has not been established. The aim of this study was to
determine the efficacy and safety of 5-aminolevulinic acid (5-ALA-PDT)
for keloids that are unresponsive to intralesional steroid injection.
This study included 14 patients with 15 keloids that had not responded
to a minimum of three intralesional injections of triamcinolone
acetonide. Keloids were treated with 20% 5-ALA cream under occlusion for
4 hours before irradiation with a red light source. PDT was repeated
once a month for a maximum of three times. Scar height was measured
monthly during the treatment and follow-up periods. Clinical improvement
was defined primarily on the basis of scar height reduction. Pre- and
post-treatment mean values for scar heights were statistically compared.
Five patients (50%) showed complete disappearance of their keloids, one
patient (10%) showed partial clearance (greater than 50% decrease), and
four patients (40%) had stable disease (less than 50% decrease). Given
its noninvasiveness, minimal adverse effects, and good cosmetic results,
5-ALA-PDT is a promising alternative treatment for keloids. Further
studies with a larger cohort of patients would be of value. |
