Study Examines Aminolevulinic Acid Photodynamic Therapy for Psoriasis

A recent study examined the clinical evidence related to photodynamic therapy for psoriasis, which showed promise in the early 1990s as a treatment of plaque clearance following topical aminolevulinic acid-photodynamic therapy (ALA-PDT). In December 2013, the researchers conducted a systematic search of the PubMed Medlin database using the keywords “psoriasis” and “photodynamic therapy.”
 
They found that numerous clinical studies failed to demonstrate a consistent, efficacious response to topical ALA-PDT. In addition, severe pain and often intolerable burning sensations were repeatedly reported. Therefore, the researchers concluded that the variability in clinical response and the painful side effects have made topical ALA-PDT an unsuitable treatment option for chronic plaque psoriasis. Nonetheless, early clinical studies of other modalities such as topical hypericin and methylene blue, as well as systemic ALA and verteporfin, have shown that these photosensitizers are efficacious and much better tolerated than topical ALA.
 
“With the current landscape of phototherapy dominated by psoralen combined with ultraviolet A (PUVA) and narrowband ultraviolet B (NB-UVB), an alternative light therapy utilizing the visible spectrum is certainly promising and a worthwhile endeavor to pursue,” they concluded.
 
Choi YM, Adelzadeh L, Wu JJ. Photodynamic therapy for psoriasis. J Dermatolog Treat. Published online ahead of print. June 17, 2014.