Photodynamic therapy is more effective than imiquimod for actinic keratosis in organ transplant recipients: a randomized intraindividual controlled trial. (1st April 2018)

• Record Type: Journal Article
• Authors: Togsverd‐Bo, K.; Halldin, C.; Sandberg, C.; Gonzalez, H.; Wennberg, A.M.; Sørensen, S.S.; Wulf, H.C.; Hædersdal, M.
• Is Part Of: British journal of dermatology. Volume 178:Number 4(2018)
• Page Start: e298
• Page End: e298
• Publication Date: 2018-04-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.16507
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Recipients of organ transplants such as a kidney must take strong drugs to prevent organ rejection. These drugs also reduce the body's defences against the development of cancer. This is particularly important in the skin, where damage from ultraviolet light from the sun leads to precancerous changes (solar keratoses) on exposed sites. These changes can be extensive and are more likely to develop into aggressive skin cancers than in normal healthy individuals. This Scandinavian study compares the effectiveness and acceptability of two established treatments for solar keratoses in a group of 35 organ transplant patients. Photodynamic therapy (PDT) is administered at a hospital visit. It involves applying a light‐sensitising cream to the skin which is later activated by a red light. This triggers intense inflammation in the skin which destroys abnormal but not normal tissue. Another treatment is imiquimod cream which is applied three times a week for four weeks by the patient at home. It stimulates the body's own defence mechanisms to fight off abnormal tissue changes. Each patient had two similarly affected areas of skin. These were randomly allocated to be treated either with PDT or imiquimod. PDT was repeated after three, and imiquimod after two months if necessary. Response rates were calculated at three and six months. This study showed that photodynamic therapy was more effective than imiquimod at reducing the number of persistent solar keratoses in this group of high‐risk patients. Although PDT was more painful than imiquimod, patients did not prefer one treatment over the other for this reason.