Papers of The 2nd Japan Scar Workshop

18. Treatment of keloids with photodynamic therapy using 5-aminolevulinic acid (5-ALA-PDT): a preliminary study

Mamiko Tosa1, Masahiro Murakami1, Itaru Iwakiri1, Hiroki Umezawa1, Hiko Hyakusoku2

1:Department of Plastic and Reconsrtructive Surgery, Nippon Medical school Musashikosugi Hospital, Kawasaki, Japan
2:Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan

Numerous treatment modalities have been used to treat keloids, but the optimal treatment has not been established. The aim of this study was to determine the efficacy and safety of 5-aminolevulinic acid (5-ALA-PDT) for keloids that are unresponsive to intralesional steroid injection. This study included 14 patients with 15 keloids that had not responded to a minimum of three intralesional injections of triamcinolone acetonide. Keloids were treated with 20% 5-ALA cream under occlusion for 4 hours before irradiation with a red light source. PDT was repeated once a month for a maximum of three times. Scar height was measured monthly during the treatment and follow-up periods. Clinical improvement was defined primarily on the basis of scar height reduction. Pre- and post-treatment mean values for scar heights were statistically compared. Five patients (50%) showed complete disappearance of their keloids, one patient (10%) showed partial clearance (greater than 50% decrease), and four patients (40%) had stable disease (less than 50% decrease). Given its noninvasiveness, minimal adverse effects, and good cosmetic results, 5-ALA-PDT is a promising alternative treatment for keloids. Further studies with a larger cohort of patients would be of value.
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