Photodynamic therapy for rosacea in Chinese patients

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d428318e155">Background:</h5> <p id="P1">Rosacea is a common chronic cutaneous disorder which is characterized by flushing, erythema, papulopustules and telangiectasia. The pathogenesis of the disease is still unknown. A multifaceted approach is necessary to control the disease because of its tendency to relapse. New more effective treatment options are desirable to achieve a complete remission. Aminolevulinic acid–photodynamic therapy (ALA-PDT) is a well-established treatment for non-melanoma skin cancer and precancerous lesions. ALA-PDT can also be used for inflammatory disease, including acne vulgaris. However, little is known about the efficacy and safety of ALA-PDT for rosacea in Chinese patients with Fitzpatrick skin types III and IV. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d428318e160">Objectives:</h5> <p id="P2">To investigate the efficacy and safety of ALA-PDT in the treatment of rosacea classified as erythematotelangiectatic type or papulopustular type. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d428318e165">Methods:</h5> <p id="P3">Twenty rosacea patients with either erythematotelangiectatic or papulopustular types were enrolled. 5% 5-Aminolevulinic acid in an oil-in-water emulsion was applied to the lesions under occlusion with plastic film for 2h, and the lesions were irradiated with 100 mW/cm ², 80-90 J/cm ², LED red light (635 ± 15 nm) over 15 minutes in each session with four sessions at 10-day intervals. Objective measures (severity of flushing, erythema and telangiectasia, number of inflammatory lesions, VISIA Red Complexion Analysis images), subjective symptoms (including itching, prickling, burning, <i>etc.)</i> were recorded at baseline and at 4, 12 and 24 weeks after the last treatment. Adverse effects were recorded at each treatment and follow-up visit. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d428318e179">Results:</h5> <p id="P4">During the follow-up period, all patients showed gradual objective clinical improvement compared with baseline (P&lt;0.01). Clinical inflammatory lesions disappeared completely in all patients after 24 weeks. Subjective symptoms, including flushing, itching, prickling, burning <i>et at</i>, had vanished and did not show any relapse during the follow-up period. The main side effects of ALA-PDT were pain, erythema, swelling and post- inflammatory hyperpigmentation. All side-effects were transient and tolerated by all the patients. No patients were dissatisfied with the therapeutic outcome. </p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d428318e187">Conclusions:</h5> <p id="P5">ALA-PDT is an effective and safe approach for the treatment of rosacea of erythematotelangiectatic or papulopustular types, to control clinical manifestations and reduce subjective symptoms. </p> </div>