Photodynamic therapy combined with curettage for actinic keratosis on the face and scalp: An efficient treatment for field cancerization of the skin

IF 3.1 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-03-13 DOI:10.1016/j.pdpdt.2025.104553

Chi Zhang , Tian Wang , Wenna Lu , Ruixue Chang , Yuanjing Zhang

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引用次数: 0

Abstract

Background

Actinic keratosis (AK) frequently manifests as multiple regional lesions on the exposed areas of the face and scalp. The simultaneous treatment of extensive lesions with varying degrees poses a significant challenge.

Objective

This study evaluated the efficacy and patient satisfaction of 5-aminolevulinic acid (5-ALA) photodynamic therapy (PDT) combined with curettage in managing extensive AK on the face and scalp.

Methods

A retrospective analysis was conducted on patients with AK on the face and scalp treated at the dermatology department of a large hospital in a central Chinese city from 2020 to 2024. Each patient was histopathologically confirmed, exhibited a large lesion area exceeding 10 cm², and demonstrated evident field cancerization. All patients underwent curettage followed by 5-ALA PDT. During a 6-month follow-up, patient self-assessment and physician evaluations were conducted to systematically assess the treatment's efficacy, satisfaction, and adverse reactions.

Results

Fifty-six patients (38 females, 18 males) with a mean age of 76.26±9.16 years were included. Significant improvement in skin was observed, with the lesion count decreasing from 12.33±9.09 pretreatment to 1.98±1.50 post-treatment. Pain scores (VAS) decreased from 2.89±2.20 to 0.75±1.03, pruritus scores (NAS) from 2.46±0.95 to 0.51±0.73, and dermatology life quality index (DLQI) scores from 9.12±4.46 to 2.59±2.17. The primary adverse effect was pain during PDT.

Conclusion

Curettage combined with 5-ALA PDT is an efficacious, safe, and efficient treatment for field cancerization of extensive AK on the face and scalp, warranting its promotion in clinical practice.

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光动力疗法联合刮痧治疗面部和头皮光化性角化病：一种有效的野地癌变治疗方法。

背景：光化性角化病（AK）通常表现为面部和头皮暴露区域的多个区域病变。同时治疗不同程度的广泛病变是一项重大挑战。目的：评价5-氨基乙酰丙酸（5-ALA）光动力疗法（PDT）联合刮痧治疗面部和头皮广泛性AK的疗效和患者满意度。方法：对中部某市某大型医院皮肤科2020 - 2024年收治的面部及头皮AK患者进行回顾性分析。每位患者均经组织病理学证实，病变面积大于10 cm²，并表现出明显的野区癌化。所有患者均行刮除后5-ALA PDT。在6个月的随访中，进行患者自我评估和医师评估，系统评估治疗的疗效、满意度和不良反应。结果：共纳入56例患者，其中女性38例，男性18例，平均年龄76.26±9.16岁。皮肤改善明显，病变数由治疗前的12.33±9.09降至治疗后的1.98±1.50。疼痛评分（VAS）由2.89±2.20降至0.75±1.03，瘙痒评分（NAS）由2.46±0.95降至0.51±0.73，皮肤生活质量指数（DLQI）由9.12±4.46降至2.59±2.17。主要不良反应是PDT期间的疼痛。结论：刮痧联合5-ALA PDT治疗面部及头皮广泛AK野区癌变是一种有效、安全、高效的治疗方法，值得在临床推广应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.