Cyclic photodynamic therapy delays first onset of actinic keratoses in renal transplant recipients: a 5-year randomized controlled trial with 12-month follow-up

Journal of the European Academy of Dermatology & Venereology. 2022;36(11):e946-e948

CET Conclusion

Reviewer: Mr Simon Knight, Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences University of Oxford
This letter to the editor describes long-term follow-up of a randomised controlled trial of cyclic photodynamic therapy for actinic keratosis (AK) protection in renal transplant recipients with no baseline dysplasia. Patients in the study arm were treated on the face, forearm and hand at 6-month intervals for 5 years, with the contralateral side acting as a control. AK lesions appeared earlier in untreated skin (median 28 vs. 40 months) with lower probability of AK-free skin. There were no differences in incidence of SCC or BCC. These findings are interesting, although the sample is too small to determine a difference in eventual skin cancers. It should be noted that of the 46 patients recruited, only 70% attended all study visits reducing power further. Nevertheless, the findings suggest that PDT does reduce the speed and number of AK lesions developing in renal transplant recipients, and may be of use particularly in high-risk patients and regions.

Study details

Aims : This study aimed to report the 6-year follow-up data of a randomised controlled trial investigating whether cyclic photodynamic therapy (PDT) was effective in reducing or delaying the development of actinic keratoses (AK) in kidney transplant patients with no baseline skin dysplasia.
Interventions : Participants were randomly assigned to receive split-side PDT of the face, dorsal forearm and hand, with the contralateral side serving as untreated control.
Participants : 46 renal transplant recipients with no previous or current AK, keratinocyte carcinoma (KC) or PDT treatment.
Outcomes : The main outcomes of interest were total number of AKs, time to onset of first AK in the treatment areas, and number of non-melanoma skin cancers including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Follow up : 6 year

Metadata

Funding : Industry funding
Publication type : Randomised Controlled Trial
Trial registration : EudraCT 2008-006863-35
Organ : Kidney
Language : English
Author email : katrine.togsverd-bo@regionh.dk