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. 2022 Sep;12(9):2049-2061.
doi: 10.1007/s13555-022-00783-1. Epub 2022 Jul 30.

Randomized Clinical Trial of Conventional versus Indoor Daylight Photodynamic Therapy for Treatment of Actinic Cheilitis

Mariachiara Arisi  1 , Benedetta Galli  2 , Edoardo Guasco Pisani  2 , Giuseppe La Rosa  2 , Gaetano Licata  2 , Sara Rovaris  2 , Cesare Tomasi  2 , Mariateresa Rossi  2 , Marina Venturini  2 , Luigi Spiazzi  3 , PierGiacomo Calzavara-Pinton  2
Affiliations

Randomized Clinical Trial of Conventional versus Indoor Daylight Photodynamic Therapy for Treatment of Actinic Cheilitis

Mariachiara Arisi et al. Dermatol Ther (Heidelb). 2022 Sep.

Abstract

Introduction: Actinic cheilitis (AC) is the biologic precursor of invasive squamous cell carcinoma (SCC) of the vermilion, and different treatment options have been investigated, but their efficacy is hampered by local inflammation, pain and slow recovery. Daylight photodynamic therapy (dl-PDT) has been demonstrated to represent a valuable treatment option for AC, but its feasibility is limited by weather conditions and latitude.

Methods: Our study proposed to compare the efficacy and tolerability of conventional photodynamic therapy (c-PDT) and indoor daylight photodynamic therapy (idl-PDT) with a white LED lamp for the treatment of AC. Sixteen patients were enrolled in the study: 8 (50%) treated with c-PDT and 8 (50%) treated with idl-PDT. All patients completed the study protocol.

Results: Both idl-PDT and c-PDT were demonstrated to be highly effective in terms of reduction of the cumulative lesional area and severity of the clinical score. Neither treatment was inferior to the other. The inflammatory reaction and the pain scores were milder with idl-PDT, whereas the cosmetic outcome was not different.

Conclusion: The present findings confirm that idl-PDT can represent a valid therapeutic strategy for AC patients as well, despite the procedural difficulties and the risk of poor tolerability related to the body site.

Keywords: Actinic cheilitis; Conventional photodynamic therapy; Daylight photodynamic therapy; Indoor daylight photodynamic therapy; Photodynamic therapy.

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Figures

Fig. 1
Fig. 1
Comparison of AC area (cm2) (a) and severity score (b) according to treatment options at baseline (T0): no statistically significant difference
Fig. 2
Fig. 2
AC cumulative area and severity clinical score at baseline (T0) and 3 months follow-up (T1) after c-PDT (a, b) and idl-PDT (c, d). *Statistically significant
Fig. 3
Fig. 3
Comparison of AC cumulative area (cm2) (a) and severity clinical score (b) change according to treatment options (Δ = T0 − T1): no statistically significant difference
Fig. 4
Fig. 4
Clinical assessment of AC before and after c-PDT (a, b) and idl-PDT (c, d)
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