| DERMATOLOGY | PEER-REVIEW
(chest/dorsal skin) after topical application of MAL in cream formulation. This analysis confirmed a sufficient localized accumulation of photosensitizer within affected tissues. SSF measurement following SBRR-MAL- PDT photo-bleaching (SSF-3) showed a return to normal pre-treatment baseline values, confirming the PDT efficacy produced by the subsequent triple light exposure sequence. This trend was evident in the entire study population, both considered as a whole or subdivided into the two anatomical distribution sites. When the total number of participants was considered,
the difference between initial skin fluorescence measurements (SSF-1) and those taken after topical MAL- OCT (SSF-2) was statistically significant, revealing higher SSF levels at SSF-2 compared to SFF-1 (p<0.001). Mean baseline SSF values were 7.07 FDU, while those measured after topical MAL-OCT, jumped to a mean of 25.68 FDU, an almost 4-fold increase to the baseline values. After completion of SBRR-MAL-PDT procedures,
photo-bleaching was found to be almost complete, reaching a mean SSF level (SSF-3) of 9.15 FDU, almost as low as pre-treatment baseline values (SSF-1). The difference between SSF-2 FDU and SSF-3 FDU was statistically significant (p<0.001), demonstrating that selective tissue accumulations of photo-sensitizer (PpIX) have been almost completely consumed by SBRR-MAL- PDT (Figure 4). These measurements allow operators to
have full control over all subsequent steps of PDT procedures, which can therefore no longer be considered as ‘blind’ as the operator will be aware of the effects of treatment. Data analysis for the facial acne subgroup confirmed
the same trend, with SSF levels significantly higher at SSF-2 (p<0.001) and significantly lower at SSF-3. (p<0.001 ) (Figure 5). Similar results were evident when the chest/ dorsal skin subgroup was considered.
Subjective evaluation of SBRR-PDT by patients Thirty out of a total patient population of 39 subjects completed the self-assessment questionnaire given to them to complete the study.
Pain during and after treatment Pain perception experienced by patients during active PDT treatment scored a mean of 5.71 (first session) and 5.57 (second session) on a printed 10 point VAS scale. Pain perception was reported lower during the 24 hours following PDT, scoring a mean of 3.87 after the first SBRR- MAL-PDT session, and a mean of 3.29 following the second session (Table 4).
Side-effects and adverse events The main side-effect reported by patients after the first SBRR-MAL-PDT session was erythema (67.74%) followed
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