Treatment of Actinic Cheilitis Using Photodynamic Therapy with Methylaminolevulinate: Report of Three Cases

Abstract

Patients with actinic cheilitis should be treated to prevent transformation into invasive squamous cell carcinoma. Treatment options comprise, for instance, destructive approaches, such as vermilionectomy and carbon dioxide laser ablation. Photodynamic therapy (PDT) has demonstrated high efficacy in patients with epithelial skin cancers, but there is only one report on PDT with free d-aminolevulinic acid (ALA) and noncoherent light in the treatment of actinic cheilitis.

We report the treatment of three patients with actinic cheilitis with PDT using the new photosensitizing agent methylaminolevulinate (methyl-5-amino-4-oxopenthanoate [MAOP]) combined with red light.

MAOP was topically applied on the lower lip 3 hours before treatment with red light. Two consecutive treatments, 1 week apart, were administered. Clinical assessment was performed up to 13 months after the initial treatment.

A good clinical response with an excellent cosmetic outcome was observed in all three patients. Moderate to severe pain was associated with the application of the red light, and mild inflammation with edema of the lower lip occurred.

This is the first use of PDT with MAOP and 634 mm wavelength red light in patients with actinic cheilitis. The clinical results demonstrate that PDT might be an alternative for patients who refuse surgical procedures. However, further studies are needed to compare the efficacy and cosmetic outcome with conventional treatment modalities.