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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Actinic keratosis &#40;AK&#41; is one of the most common skin diseases seen in clinical practice&#46; In the last 5 years&#44; several studies assessing the efficacy of photodynamic therapy in the treatment of multiple AKs have been published&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">We aimed to assess the clinical outcomes of photodynamic therapy in patients with multiple AKs and the correlation of those outcomes with fluorescence imaging&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">In this retrospective&#44; descriptive&#44; observational study of 57 patients treated in our hospital with photodynamic therapy for multiple AKs&#44; we recorded age&#44; sex&#44; and lesion site &#40;face&#44; scalp&#44; and dorsum of the hands&#41;&#46; All patients were treated in the same way&#58; methyl aminolevulinic acid &#40;Metvix<span class="elsevierStyleSup">&#174;</span>&#41; was applied for 3 hours and the skin then irradiated with red light at 630 nm&#44; 37 J&#47;cm<span class="elsevierStyleSup">2</span>&#44; for 7&#46;5 minutes &#40;Aktilite<span class="elsevierStyleSup">&#174;</span>&#41;&#46; The response&#44; remission duration&#44; tolerance&#44; number of sessions&#44; and fluorescence images were recorded by site&#46; The &#967;<span class="elsevierStyleSup">2</span> test was used to assess between-site differences and the correlation between fluorescence imaging and clinical response&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The greatest improvements were obtained for facial lesions&#59; these required fewer sessions and remission lasted longer than lesions at other sites&#46; The treatment was best tolerated on the dorsum of the hands&#46; The fluorescence area and the reduction in intensity on applying treatment were found to be strongly and significantly correlated with the extent of clinical response&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Overall&#44; the outcomes of treatment of multiple AKs with photodynamic therapy are better for the face than for the scalp and dorsum of the hands&#46; Fluorescence imaging may be an effective tool for predicting response to treatment&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">Las queratosis act&#237;nicas &#40;QA&#41; son una de las patolog&#237;as cut&#225;neas m&#225;s frecuentes en la pr&#225;ctica cl&#237;nica&#46; En los &#250;ltimos 5 a&#241;os se han publicado varios estudios que evaluaban la eficacia de la terapia fotodin&#225;mica &#40;TFD&#41; en el tratamiento de m&#250;ltiples QA&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar los resultados de la TFD de m&#250;ltiples QA por localizaciones y su correlaci&#243;n con la imagen de fluorescencia&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio retrospectivo&#44; descriptivo y observacional de los pacientes tratados por m&#250;ltiples QA con TFD en nuestro hospital&#46; Se describe la edad&#44; el sexo y la localizaci&#243;n de las lesiones &#40;cara&#44; cuero cabelludo y dorso de las manos&#41; de los 57 pacientes&#46; Se trat&#243; a todos los pacientes usando los mismos par&#225;metros&#58; &#225;cido metilaminolevul&#237;nico &#40;MAL&#44; Metvix<span class="elsevierStyleSup">&#174;</span>&#41; ocluido tres horas e irradiaci&#243;n con luz roja de 630 nm&#44; 37 J&#47;cm<span class="elsevierStyleSup">2</span>&#44; 7&#44;5 minutos &#40;Aktilite<span class="elsevierStyleSup">&#174;</span>&#41;&#46; Se describe la respuesta&#44; per&#237;odo de remisi&#243;n&#44; tolerancia&#44; n&#250;mero de sesiones y la fluorescencia seg&#250;n localizaciones&#46; Con la prueba Chi-cua-drado se eval&#250;an las diferencias entre localizaciones y la correlaci&#243;n de la imagen de fluorescencia con la respuesta cl&#237;nica&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En la cara se obtiene mayor grado de mejor&#237;a&#44; se requieren menor n&#250;mero de sesiones y mayores per&#237;odos de remisi&#243;n que en el resto de las localizaciones&#46; El dorso de las manos es la zona mejor tolerada&#46; Existe una correlaci&#243;n alta y significativa entre el &#225;rea de fluorescencia y su disminuci&#243;n al aplicar el tratamiento&#44; con el grado de respuesta cl&#237;nica&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados en el tratamiento de m&#250;ltiples QA con TFD son mejores&#44; globalmente&#44; en la cara que en el cuero cabelludo y en el dorso de manos&#46; El diagn&#243;stico de fluorescencia puede ser una herramienta eficaz para predecir la respuesta al tratamiento&#46;</p>"
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                        "tituloSerie" => "J Am Acad Dermatol"
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                        "tituloSerie" => "J Am Acad Dermatol"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Terapia fotodin&#225;mica&#58; nuevas indicaciones"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            1 => "I&#46; Garc&#237;a-Morales"
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                            3 => "C&#46; Montull"
                            4 => "B&#46; P&#233;rez-Garc&#237;a"
                            5 => "P&#46; Ja&#233;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2007"
                        "volumen" => "98"
                        "paginaInicial" => "377"
                        "paginaFinal" => "395"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17663928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate &#40;Metvix<span class="elsevierStyleSup">&#174;</span>&#41; in actinic keratosis on the face and scalp"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
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                            1 => "I&#46; Rosdahl"
                            2 => "B&#46; Berne"
                            3 => "K&#46; Svanberg"
                            4 => "A&#46;M&#46; Wennberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/00015550510032887"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol"
                        "fecha" => "2005"
                        "volumen" => "85"
                        "paginaInicial" => "424"
                        "paginaFinal" => "428"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16159735"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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                      "titulo" => "Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis&#58; a prospective&#44; randomized study"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "S&#46; Radakovic-Fijan"
                            3 => "A&#46; Tanew"
                            4 => "P&#46;G&#46; Calzavara-Pinton"
                            5 => "C&#46; Zane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2002"
                        "volumen" => "47"
                        "paginaInicial" => "258"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12140473"
                            "web" => "Medline"
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                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "Photodynamic therapy with topical methyl aminolevulinate &#40;Metvix<span class="elsevierStyleSup">&#174;</span>&#41; is effective and safe in the treatment of actinic keratosis&#58; results of a prospective randomized trial"
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                            4 => "A&#46;W&#46; Lucky"
                            5 => "R&#46;J&#46; Pariser"
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                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mjd.2003.49"
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                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2003"
                        "volumen" => "48"
                        "paginaInicial" => "227"
                        "paginaFinal" => "232"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12582393"
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                    0 => array:2 [
                      "titulo" => "Intraindividual right-left comparison of topical methyl-aminolevulinate-photodynamic therapy &#40;MAL-PDT&#41; and cryotherapy in subjects with actinic keratosis&#58; a multicentre&#44; randomized controlled study"
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                            1 => "S&#46; Campbell"
                            2 => "G&#46; Gupta"
                            3 => "S&#46; Keohane"
                            4 => "J&#46; Lear"
                            5 => "I&#46; Zaki"
                          ]
                        ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2006.07470.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2006"
                        "volumen" => "155"
                        "paginaInicial" => "1029"
                        "paginaFinal" => "1036"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17034536"
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                            2 => "D&#46; Francis"
                            3 => "L&#46; Spelman"
                            4 => "R&#46; Nguyen"
                            5 => "P&#46; Fergin"
                          ]
                        ]
                      ]
                    ]
                  ]
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                        "volumen" => "14"
                        "paginaInicial" => "99"
                        "paginaFinal" => "106"
                      ]
                    ]
                  ]
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                            5 => "A&#46;M&#46; Ros"
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                        "link" => array:1 [
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Journal Information
Vol. 99. Issue 10.
Pages 779-787 (December 2008)
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Vol. 99. Issue 10.
Pages 779-787 (December 2008)
Original articles
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Retrospective, Descriptive, Observational Study of Treatment of Multiple Actinic Keratoses With Topical Methyl Aminolevulinate and Red Light: Results in Clinical Practice and Correlation With Fluorescence Imaging
Estudio Retrospectivo, Descriptivo y Observacional del Tratamiento de Queratosis Actínicas Múltiples con Metilaminolevulinato Tópico y Luz Roja: Resultados en la Práctica Clínica y Correlación con la Imagen de Fluorescencia
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M. Fernández-Guarinoa,
Corresponding author
montsefdez@msn.com

Correspondence: Hospital Ramón y Cajal, Carretera de Colmenar km. 9.100, 28034 Madrid, Spain.
, A. Hartoa, M. Sánchez-Roncob, B. Pérez-Garcíaa, A. Marqueta, P. Jaéna
a Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain
b Departamento de Ciencias Sanitarias y Médico-Sociales, Facultad de Medicina, Universidad de Alcalá de Henares, Madrid, Spain
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Article information
Abstract
Background

Actinic keratosis (AK) is one of the most common skin diseases seen in clinical practice. In the last 5 years, several studies assessing the efficacy of photodynamic therapy in the treatment of multiple AKs have been published.

Objective

We aimed to assess the clinical outcomes of photodynamic therapy in patients with multiple AKs and the correlation of those outcomes with fluorescence imaging.

Material and methods

In this retrospective, descriptive, observational study of 57 patients treated in our hospital with photodynamic therapy for multiple AKs, we recorded age, sex, and lesion site (face, scalp, and dorsum of the hands). All patients were treated in the same way: methyl aminolevulinic acid (Metvix®) was applied for 3 hours and the skin then irradiated with red light at 630 nm, 37 J/cm2, for 7.5 minutes (Aktilite®). The response, remission duration, tolerance, number of sessions, and fluorescence images were recorded by site. The χ2 test was used to assess between-site differences and the correlation between fluorescence imaging and clinical response.

Results

The greatest improvements were obtained for facial lesions; these required fewer sessions and remission lasted longer than lesions at other sites. The treatment was best tolerated on the dorsum of the hands. The fluorescence area and the reduction in intensity on applying treatment were found to be strongly and significantly correlated with the extent of clinical response.

Conclusions

Overall, the outcomes of treatment of multiple AKs with photodynamic therapy are better for the face than for the scalp and dorsum of the hands. Fluorescence imaging may be an effective tool for predicting response to treatment.

Key words:
photodynamic therapy
actinic keratosis
methyl aminolevulinate
red light
fluorescence diagnosis
Resumen
Introducción

Las queratosis actínicas (QA) son una de las patologías cutáneas más frecuentes en la práctica clínica. En los últimos 5 años se han publicado varios estudios que evaluaban la eficacia de la terapia fotodinámica (TFD) en el tratamiento de múltiples QA.

Objetivo

Evaluar los resultados de la TFD de múltiples QA por localizaciones y su correlación con la imagen de fluorescencia.

Material y métodos

Realizamos un estudio retrospectivo, descriptivo y observacional de los pacientes tratados por múltiples QA con TFD en nuestro hospital. Se describe la edad, el sexo y la localización de las lesiones (cara, cuero cabelludo y dorso de las manos) de los 57 pacientes. Se trató a todos los pacientes usando los mismos parámetros: ácido metilaminolevulínico (MAL, Metvix®) ocluido tres horas e irradiación con luz roja de 630 nm, 37 J/cm2, 7,5 minutos (Aktilite®). Se describe la respuesta, período de remisión, tolerancia, número de sesiones y la fluorescencia según localizaciones. Con la prueba Chi-cua-drado se evalúan las diferencias entre localizaciones y la correlación de la imagen de fluorescencia con la respuesta clínica.

Resultados

En la cara se obtiene mayor grado de mejoría, se requieren menor número de sesiones y mayores períodos de remisión que en el resto de las localizaciones. El dorso de las manos es la zona mejor tolerada. Existe una correlación alta y significativa entre el área de fluorescencia y su disminución al aplicar el tratamiento, con el grado de respuesta clínica.

Conclusiones

Los resultados en el tratamiento de múltiples QA con TFD son mejores, globalmente, en la cara que en el cuero cabelludo y en el dorso de manos. El diagnóstico de fluorescencia puede ser una herramienta eficaz para predecir la respuesta al tratamiento.

Palabras clave:
terapia fotodinámica
queratosis actínicas
metilaminolevulinato
luz roja
diagnóstico de fluorescencia
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References
[1.]
M.P. Golman.
Terapia fotodinámica.
1.ª ed., Editorial Elsevier, (2006),
[2.]
R.G. Glogau.
The risk of progression to invasive disease.
J Am Acad Dermatol, 42 (2000), pp. 23-24
[3.]
Y. Gilaberte, C. Serra-Guillén, M.E. de las Heras, R. Ruiz-Rodríguez, M. Fernández-Lorente, C. Benvenuto-Andrade, et al.
Terapia fotodinámica en Dermatología.
Actas Dermosifiliogr, 97 (2006), pp. 83-102
[4.]
A. Marquet, M. Fernández-Guarino, B. Pérez-García, A. Harto, P. Jaén.
Terapia fotodinámica en dermatología.
Dermatología Práctica, 14 (2006), pp. 30-35
[5.]
T. Smits, C. Robles, P.E. Van Erp, P.C. Van der Kerhof, M.J. Gerritsen.
Correlation between ppIX and fluorescence diagnosis in psoriasis and actinic keratoses using a digital fluorescence imaging system.
Book of Abstracts of the Annual Meeting of the European Society for Photodynamic Therapy, pp. 57
[6.]
E.A. Olsen, L. Abernethy, C. Kulp-Shorten, J.P. Callen, S.D. Glazer, A. Huntley, et al.
A double-blind, vehicle-controlled study evaluating masoprocol cream in the treatment of actinic keratoses on the head and neck.
J Am Acad Dermatol, 5 (1991), pp. 738-743
[7.]
M. Fernández-Guarino, I. García-Morales, A. Harto, C. Montull, B. Pérez-García, P. Jaén.
Terapia fotodinámica: nuevas indicaciones.
Actas Dermosifiliogr, 98 (2007), pp. 377-395
[8.]
M. Tarstedt, I. Rosdahl, B. Berne, K. Svanberg, A.M. Wennberg.
A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate (Metvix®) in actinic keratosis on the face and scalp.
Acta Derm Venereol, 85 (2005), pp. 424-428
[9.]
R.M. Szeimies, S. Barrer, S. Radakovic-Fijan, A. Tanew, P.G. Calzavara-Pinton, C. Zane, et al.
Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: a prospective, randomized study.
J Am Acad Dermatol, 47 (2002), pp. 258-262
[10.]
D.M. Pariser, N.J. Lowe, D.M. Stewar, M.T. Jarratt, A.W. Lucky, R.J. Pariser, et al.
Photodynamic therapy with topical methyl aminolevulinate (Metvix®) is effective and safe in the treatment of actinic keratosis: results of a prospective randomized trial.
J Am Acad Dermatol, 48 (2003), pp. 227-232
[11.]
C. Morton, S. Campbell, G. Gupta, S. Keohane, J. Lear, I. Zaki, et al.
Intraindividual right-left comparison of topical methyl-aminolevulinate-photodynamic therapy (MAL-PDT) and cryotherapy in subjects with actinic keratosis: a multicentre, randomized controlled study.
Br J Dermatol, 155 (2006), pp. 1029-1036
[12.]
M. Freeman, C. Vinciullo, D. Francis, L. Spelman, R. Nguyen, P. Fergin, et al.
A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix®) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study.
J Dermatol Treat, 14 (2003), pp. 99-106
[13.]
M.B. Ericson, C. Sandberg, B. Stenquist, F. Gudmundson, M. Karlsson, A.M. Ros, et al.
Photodynamic therapy for actinic keratosis at varying fluence rates: assessment of photobleaching, pain and primary clinical outcome.
Br J Dermatol, 151 (2004), pp. 1204-1212
Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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