Treatment of hidradenitis suppurativa by photodynamic therapy with aminolevulinic acid: preliminary results
Schweiger, E.S.; Riddle, C.C.; Aires, D.J.
Journal of Drugs in Dermatology Jdd 10(4): 381-386
2011
ISSN/ISBN: 1545-9616 PMID: 21455548 Document Number: 15801
The current standard of care for hidradenitis suppurativa (HS) includes antibiotics (oral/topical), retinoids (oral/topical) and intralesional steroids and is unsatisfactory. Photodynamic therapy (PDT) with 20% 5-aminolevulinic acid (ALA) has been used ?off label? to treat acne vulgaris and may hold promise as a therapy for HS. This open-label, non-blinded study investigated the efficacy and safety of ALA PDT for the treatment of HS using two blue light sources and intense pulsed light (IPL) for photoactivation. Twelve subjects with active HS enrolled to undergo ALA PDT once weekly for four weeks with follow-up visits 4, 8, and 12 or more weeks later. Nine subjects completed the study through the week 8 follow-up visit. Lesions were counted at each treatment visit at week 4, week 8 and at the final week. Mean lesion counts were 11.25 at baseline, 6.5 at 4 weeks (50.8% reduction), and 7.5 at 8 weeks (29.9% reduction). Mean Global Severity Scores were 2.2 at baseline, 1.5 at 4 weeks, and 1.8 at 8 weeks. Mean DLQI scores were 17.3 at baseline, 13.1 at 4 weeks (27.2% improvement), 14.00 at 8 weeks (19.3% improvement) and 14.0 (19.3% improvement) at the final week (16-62 weeks). Three subjects (25%) had complete clearance and no active lesions 4 weeks after the final treatment. Treatments were more tolerable for subjects treated with blue light than with IPL. ALA PDT may be a safe and effective treatment of hidradenitis suppurativa.
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