A1 Journal article (refereed)
Ablative fractional laser‐assisted photodynamic therapy for lentigo maligna : a prospective pilot study (2020)


Räsänen, J.E.; Neittaanmäki, N.; Jeskanen, L.; Pölönen, I.; Snellman, E.; Grönroos, M. (2020). Ablative fractional laser‐assisted photodynamic therapy for lentigo maligna : a prospective pilot study. Journal of the European Academy of Dermatology and Venereology, 34 (3), 510-517. DOI: 10.1111/jdv.15925


JYU authors or editors


Publication details

All authors or editors: Räsänen, J.E.; Neittaanmäki, N.; Jeskanen, L.; Pölönen, I.; Snellman, E.; Grönroos, M.

Journal or series: Journal of the European Academy of Dermatology and Venereology

ISSN: 0926-9959

eISSN: 1468-3083

Publication year: 2020

Volume: 34

Issue number: 3

Pages range: 510-517

Publisher: Wiley-Blackwell Publishing Ltd.

Publication country: United Kingdom

Publication language: English

DOI: http://doi.org/10.1111/jdv.15925

Open Access: Publication channel is not openly available

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/65412


Abstract

Background
Lentigo maligna (LM) is an in‐situ form of melanoma carrying a risk of progression to invasive lentigo maligna melanoma (LMM). LM poses a clinical challenge, with subclinical extension and high recurrence rates after incomplete surgery. Alternative treatment methods have been investigated with varying results. Photodynamic therapy (PDT) with methylaminolaevulinate (MAL) has already proved promising in this respect.

Objectives
To investigate the efficacy of ablative fractional laser (AFL)‐assisted PDT with 5‐aminolaevulinic acid nanoemulsion (BF‐200 ALA) for treating LM.

Methods
In this non‐sponsored, prospective pilot study ten histologically verified LMs were treated with AFL‐assisted PDT three times at two week intervals using a light dose of 90 J/cm2 per treatment session. Local anaesthesia with ropivacain was used. Four weeks after the last PDT treatment the lesions were treated surgically with a wide excision and sent for histopathological examination. The primary outcome was complete histopathological clearance of the LM from the surgical specimen. Patient‐reported pain during illumination and the severity of the skin reaction after the PDT treatments were monitored as secondary outcomes.

Results
The complete histopathological clearance rate was 7 out of 10 LMs (70%). The pain during illumination was tolerable, with the mean pain scores for the PDT sessions on a visual assessment scale ranging from 2.9 to 3.8. Some severe skin reactions occurred during the treatment period, however.

Conclusions
AFL‐assisted PDT showed moderate efficacy in terms of histological clearance. It could constitute an alternative treatment for lentigo maligna but due to the side‐effects it should only be considered in inoperable cases.


Keywords: photodynamic therapy; laser therapy; melanoma

Free keywords: lentigo maligna; photodynamic therapy; ablative fractional laser; 5-aminolaevulinic acid nanoemulsion; BF-200 ALA


Contributing organizations


Ministry reporting: Yes

Reporting Year: 2020

Preliminary JUFO rating: 1


Last updated on 2020-18-08 at 13:11