Maui Derm 2016 Highlights: Cutaneous Oncology


George Martin, MD
Eggert Stockfleth, MD
Ted Rosen, MD
Brian Berman, MD, PhD

ALA PDT can be made “painless” by incubating ALA for 15 mins on the skin followed by 1-hour of blue light activation (BLU-U). AK clearance rates appear to be equivalent to conventional (but off-label) 1-hour ALA incubation PDT in a small scale split face study and clinical experience in over 120 patients.

AKs are a chronic disease. Consider a chemoprevention strategy that includes not only sunscreens, topical retinoids and Vitamin B3 (nicotinamide 500 bid) and the use of 3.75% imiquimod daily for 1 week, 2 weeks off then once weekly indefinitely. Immune stimulation over time limits AK recurrences during a pilot study.

Field therapy is an essential component of the treatment of patients with actinic keratoses (AKs), and the presence of these lesions is a biomarker for field cancerization (the combination of visible AKs and subclinical lesions).