Pigmented pathological type and depth of follicular extension as predictors of treatment failure in 5-aminolevulinic acid photodynamic therapy for actinic keratosis: A retrospective, matched nested case-control study
5-Aminolevulinic acid photodynamic therapy (ALA-PDT) is commonly used for actinic keratosis (AK), but resistance and recurrence remain problematic. This study analyzed 119 patients with histologically confirmed AK treated with four ALA-PDT sessions to identify predictors of treatment effectiveness. Initial complete clearance (ICC) at 3 months and sustained complete clearance (SCC) at 12 months were assessed. ICC was achieved in 89% (106/119) of patients, with 79% (65/82) maintaining SCC. Pigmented AK predicted treatment resistance (OR=44.05, p=0.00). Follicular extension to the isthmus or deeper predicted recurrence (OR=17.26, p=0.00). Pigmented AK and deep follicular extension are independent predictors of ALA-PDT resistance and recurrence in AK, respectively.
Authors
- Huyan Chen
- Jing Luan (ORCID: https://orcid.org/0000-0001-7064-4141)
- Wenyu Wu (ORCID: https://orcid.org/0000-0002-7540-4953)
- Qiong Huang (ORCID: https://orcid.org/0000-0002-0570-5961)
- Shujun Chen (ORCID: https://orcid.org/0000-0001-7940-8655)
- Qinyuan Zhu (ORCID: https://orcid.org/0009-0008-8707-8420)
- Lianjun Chen (ORCID: https://orcid.org/0000-0002-6405-8055)
Institutions
- Huashan Hospital (CN)
Publication Details
- Journal
- Photodiagnosis and Photodynamic Therapy
- Published
- 2025-11-01
- DOI
- https://doi.org/10.1016/j.pdpdt.2025.104801
- Primary Topic
- Nonmelanoma Skin Cancer Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00