Lesions receiving red light showed significantly greater clinical clearance rate determined by dermatologist examination (94% versus 76%, P = 0-002) and lower recurrence (6% versus 38%) compared with green light (odds ratio 0^13; 95% CI 0-04-0-48). Punch biopsies were performed in cases where there was uncertainty about clinical clearance or recurrence. The authors attribute this difference to the reduced depth of tissue penetration by green light, postulating that peri-appendageal BD (which may extend up to 3 mm in depth) may survive ALA-PDT using less penetrating wavelengths. No ulceration, infection, scarring or photosensitivity reactions were reported in either group. There was no significant difference in pain between groups, and the majority of patients reported "none" to "moderate" pain.
In the unblinded controlled trial, a significant difference that a lesion of any size would clear after the first treatment with PDT compared with the first treatment with cryotherapy was observed (P< 0-01). However, there was no significant difference in the overall clearance rates between treatments following three treatments of cryotherapy (P= 0-08).94 Clinical clearance at 12-month follow up was 90% in the cryotherapy group and 100% in the PDT group.
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