Comparison of cryotherapy and photodynamic therapy in treatment of actinic keratosis

Introduction: Photodynamic therapy (PDT) of actinic keratosis (AK) using methyl aminolaevulinate (MAL) is an effective treatment option, but currently clinical observations are not yet sufficient to state superiority of this method to conventional treatment. Aims: The aim of this study was to compare treatment results of AK using cryotherapy with liquid nitrogen and MAL-PDT Material and methods: Cryosurgery and MAL-PDT were applied in 18 patients with mild to moderate AK (cryosurgery - 43 AK and MAL-PDT - 83 AK) localized symmetrically on the scalp, forehead and temple. Side effects, response to treatment, cosmetic results and patient satisfaction were analysed. Results: After 3 months total healing was observed in 87% of patients treated with MAL-PDT and in 93% of patients in whom cryosurgery was applied. Aesthetic effects, patients' comfort during the treatment and the cure period speak in favour of MAL-PDT versus cryosurgery. The rate of assessment of satisfied and very satisfied with cosmetic effects of treatment given by doctors and patients was, respectively: 78 and 89% for MAL-PDT and 56 and 67% for cryotherapy. 89% of patients preferred MAL-PDT, while only 11% of them preferred cryotherapy. Conclusions: MAL-PDT is an effective method in AK therapy, which makes it possible to achieve better cosmetic results, because it is less destructive and more selective.