Dermatology Life Quality Index and Side Effects after Topical Photodynamic Therapy of Actinic Keratosis

Background: Photodynamic therapy (PDT) is an excellent treatment option for actinic keratosis. However the side effects lead to an impairment of the patients' quality of life. Objectives: To evaluate the impact of PDT on patients' quality of life and to determine the frequency and intensity of side effects over the course of 4 weeks post PDT. Patients and Methods: 22 patients with actinic keratosis in the face were included into this prospective study. Pain was measured using a visual analog scale immediately and 8 h after PDT. The Dermatology Life Quality Index (DLQI) was assessed at screening, after treatment as well as 2 and 4 weeks after PDT. The physician and patient evaluated the intensity of side effects during the treatment, 2 and 4 weeks post PDT. Additionally, the patient documented side effects daily from the 1st to the 14th day after PDT and on day 28 post PDT, using a diary. Results: We observed a significant (p < 0.001) increase in the DLQI from 1.6 +/- 1.7 prior to PDT to 7.3 +/- 4.9 post PDT. The DLQI normalized in the following 4 weeks. Immediately and 8 h after PDT mean pain was 4.3 +/- 2.5 and 2.3 +/- 2.1. Side effects documented by the patients were erythema (100%), pain, burning, edema (90.9%), itching (86.4%), scaling (81.8%) and pustules (59.1%). No scar formation, hyper-/hypopigmentation or infections were observed. Conclusion: PDT has a significant temporary impact on patients' DLQI. Transitory side effects are common and show typical kinetics. Copyright (C) 2013 S. Karger AG, Basel