Light and laser treatment modalities for disseminated superficial actinic porokeratosis: a systematic review

Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser and light modalities in the treatment of DSAP. A systematic review of light and laser treatment modalities was conducted to include 2...

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Bibliographic Details
Published in:Lasers in medical science 2017-05, Vol.32 (4), p.945-952
Main Authors: Aird, Gregory A., Sitenga, Jenna L., Nguyen, Austin Huy, Vaudreuil, Adam, Huerter, Christopher J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Case studies
Dentistry
Female
Humans
Inflammation
Laser Therapy
Lasers
Lasers, Gas - therapeutic use
Lasers, Solid-State - therapeutic use
Light therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Optical Devices
Optics
Photochemotherapy
Photonics
Phototherapy
Pigments
Porokeratosis - surgery
Quantum Optics
Review Article
Treatment Outcome
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Summary:Treatment of disseminated superficial actinic porokeratosis (DSAP) is poorly standardized. The present review seeks to comprehensively discuss the potential for laser and light modalities in the treatment of DSAP. A systematic review of light and laser treatment modalities was conducted to include 26 cases of patients with DSAP. Systematic review resulted in 14 articles to be included. Photodynamic therapy (PDT) overall was the least successful treatment modality, with clinical improvement seen in a minority of patients (MAL-PDT: N  = 9 patients, 33.3% showed improvement; ALA-PDT: N  = 3 patients, 0% improvement; hypericin-PDT: N  = 2 patients, 0% improvement) after numerous post-procedural side effects of hyperpigmentation, inflammation, erythema, and discomfort. Overall, in the available reports, PDT demonstrates poor outcomes with greater incidence of side effects. The response rates of DSAP lesions treated with lasers were as follows: (Q-switched ruby lasers: N  = 2, 100%; CO 2 laser: N  = 1, 100%; PDT and CO 2 combination therapy: N  = 2, 0–50%; erbium and neodymium YAG lasers: N  = 2, 100%; fractional 1927-nm thulium fiber lasers: N  = 2, 100%; Grenz rays: N  = 1, 100%; and fractional photothermolysis: N  = 2, 100%). The side effects of laser therapy were minimal and included mild erythema, slight hyperpigmentation, and moderate edema. Laser therapy is a promising treatment option for DSAP with an excellent side effect profile. However, higher power studies are required to determine optimal guidelines for laser treatment of DSAP.
ISSN:0268-8921
1435-604X
DOI:10.1007/s10103-017-2179-9