Photodynamic therapy for papulopustular rosacea
Nelson K, Ehrlich A, Awosika O, Eleryan M, Al Shabeeb R, Baruffi F, and Sparks A. Photodynamic therapy for papulopustular rosacea. Lasers Surg Med 2019; 51:S7.
Lasers Surg Med
Background: Current treatments for rosacea have limited success. Reports have shown promising results in rosacea patients treated with methyl aminolevulinate photodynamic therapy (MAL - PDT). The purpose of this study was to evaluate the efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating papulopustular rosacea. Study Design/Materials and Method: This was a prospective, randomized, double-blinded pilot study of subjects (ages 18-79) with a diagnosis of papulopustular rosacea. Participants were randomized to one of three groups (groups A, B, or C). Group A subjects had their faces treated with 20% 5-ALA and irradiated with a 417nm blue light at 10 J/cm2. Group B subjects were treated with vehicle and blue light. Group C were treated with vehicle only. Each subject received a total of 4 treatments with 2-3 week intervals between treatment sessions. An Investigator's Global Assessment Score (IGA), Inflammatory Lesion Investigator's Global Assessment (ILIGA), Clinical Erythema Assessment (CEA), Inflammatory lesion count (ILC), Patient Overall Assessment scale (POA), and photographs were taken at visits. Results: Out of 30 subjects (nA=10; nB=10; nC=10), 22 fully completed the study (nA=7; nB=9; nC=6). Overall, IGA scores significantly improved (P<0.01) with Group A improving the most with an average improvement of 2.9±0.4 points (P=0.02). ILGA scores significantly improved overall for Group A (P=0.02) and there was not a significant improvement for Groups B or C (P=0.25, P=0.13 respectively). ILC, CEA, and POA improved overall for all groups (all respective P=0.01) with Group A showing the most improvement (P<0.01, P<0.01, P=0.09, respectively). Conclusion: ALA-PDT appears to be a promising therapy for the management of papulopustular rosacea as participants in Group A showed the most improvement as compared to the other subgroups. A larger, randomized controlled trial is needed to further assess the use of ALA-PDT for rosacea.