Treating field cancerization by ablative fractional laser and indoor daylight: Assessment of efficacy and tolerability

Objective: To assess if ablative fractional laser combined with indoor daylight photodynamic therapy are effective and safe for the treatment of skin field cancerization associated with actinic keratosis (AK). Methods: A total of 46 patients with field cancerized skin and AK were treated by a single session of laser assisted drug delivery (LAAD) and indoor daylight photodynamic therapy (IDL-PDT). LAAD was applied using a CO2 ablative fractional laser (AFXL) and aminolevulonic acid.Thereafter, IDL-PDT was administered using a novel device that mimics the sun radiation with a total dose of 48 J/cm2. Results: All patients showed remission following subsequent to the study protocol (complete: 71.7%, partial: 28.3%). Pain scores using a visual analog scare immediately following treatments were 9.0 ± 2.0. Conclusions: AFXL-LAAD combined with IDL-PDT is extremely effective for the treatment of skin field cancerization associated with AK. Nevertheless, the high pain scores associated with this combined approach may prove to be a limiting factor.Thus, further protocol modifications in larger scale studies are still warranted.