Pain, pain relief and other practical issues in photodynamic therapy

In our study of ALA PDT with EMLA, we noted considerable interpatient variation in the pain experience, with 5‐10% of patients experiencing quite severe pain, mainly with extensive actinic keratoses, and about the same percentage experiencing no pain at all. The remainder had an intermediate level of pain that could be managed with cool fans and cool water. 2 Assessment of the pain levels associated with treatment of different lesions types found that solar keratoses (S K) resulted in most pain, and BCC the least. Lesions on the head caused more pain than those on the trunk and extremities. On the head itself, more pain occurred on the scalp and forehead, and larger areas caused more pain than smaller areas. No differences in pain were observed for different skin types. 2

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[2]  S. Ibbotson,et al.  A randomized, double‐blind, placebo‐controlled study of the efficacy of tetracaine gel (Ametop®) for pain relief during topical photodynamic therapy , 2004, The British journal of dermatology.

[3]  M. Bulsara,et al.  Cold Air Analgesia in Photodynamic Therapy of Basal Cell Carcinomas and Bowen's Disease: An Effective Addition to Treatment A Pilot Study , 2004, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[4]  P. Seed,et al.  A randomized paired comparison of photodynamic therapy and topical 5-fluorouracil in the treatment of actinic keratoses. , 1999, Journal of the American Academy of Dermatology.

[5]  N. Bendsoe,et al.  Photodynamic therapy vs. cryosurgery of basal cell carcinomas: results of a phase III clinical trial , 2001, The British journal of dermatology.

[6]  O Larkö,et al.  Photodynamic therapy of actinic keratosis at varying fluence rates: assessment of photobleaching, pain and primary clinical outcome , 2004, The British journal of dermatology.

[7]  Hans Christian Wulf,et al.  Pain associated with photodynamic therapy using 5-aminolevulinic acid or 5-aminolevulinic acid methylester on tape-stripped normal skin. , 2003, Archives of dermatology.

[8]  M. Ericson,et al.  Pain caused by photodynamic therapy of skin cancer , 2002, Clinical and experimental dermatology.