خيارات العلاج الموصى بها بشكل مشروط للتقران الشمسي

References

DOI: 10.1016/j.jaad.2021.02.082

• The Work Group conditionally recommends the use of diclofenac, based on lower quality of evidence than that of the evidence supporting strong recommendations for the use of 5-FU or imiquimod (Table III).
• Four RCTs evaluating the efficacy and safety of 3% diclofenac in 2.5% hyaluronic acid for the treatment of AKs were identified by the systematic review (Table IV).
• However, the overall summed quality of this evidence is low; thus, the Work Group conditionally recommends ALA-red light PDT as a treatment for AKs (Table III).
• Although patch-formulated ALA is not FDA approved, 10% ALA gel is available and protocols for this drug usually dictate a 3-hour application time before 10 minutes of red light activation, which aligns with this recommendation.
• Thus, for patients with AKs, we conditionally recommend ALA-daylight PDT as less painful, but equally effective as ALA-red light PDT (Table III).
• The Work Group conditionally recommends ALA-blue light PDT as a treatment for AK, based upon this moderate quality evidence (Table III).
• Pooled data from 3 studies on up to 2 ALA-red light PDT treatments show rates of baseline lesion clearance of 89.1% and 32.7% (RR 2.89; 95% CI 2.28-3.66; P <.00001) at 12 weeks post treatment for ALA-PDT and placebo-PDT patients, respectively.