Adverse reactions of ALA-PDT for the treatment of cutaneous diseases: A retrospective study

Background: 5-Aminolaevulinic acid photodynamic therapy (ALA-PDT) is an effective therapy for cutaneous diseases, such as precancers, superficial non melanoma skin cancers and certain inflammatory or viral conditions. However, the absence of a complete picture of adverse reactions limits the promotion of ALA-PDT. Objective: To systemically investigate the detailed evidence of adverse reactions relating to ALA-PDT for skin diseases. Methods: A retrospective study performed at the Shanghai Skin Disease Hospital. Results: In the retrospective study, 439 patients were included. Incidences of adverse reactions, including in treatment pain (98.8%), erythema (92.4%), edema (35.0%), exudation (23.0%), hyperpigmentation (27.3%) were clarified. Edema was more common in female patients (P < 0.05). Patients with HPV-related skin diseases were more likely to suffer erythema, edema or exudation (P < 0.05). Hyperpigmentation was more likely to occur in skin appendage disorders (P < 0.05). Fever (2.4%) and hypopigmentation (1.9%) are two neglected adverse reactions analyzed in detail. Fever is more prevalent in female patients. Hypopigmentation occurred predominantly in elderly with skin cancer or precancerosis lesions. Conclusion: The results outline detailed information about the adverse reactions, including systemic reactions following ALA-PDT, assisting dermatologists in predicting and managing adverse reactions for greater efficacy and higher patient satisfaction.