Enhancement of Photodynamic Therapy for Bowen's Disease Using Plum-Blossom Needling to Augment Drug Delivery.

Background: Bowen's disease (BD) is treated effectively with 5-aminolevulinic acid (ALA)-photodynamic therapy (ALA-PDT). Plum-blossom needling (PBN) may enhance topical drug delivery.

Objective: To compare the effects of and adverse reactions to PBN and ALA-PDT of BD with those associated with ALA-PDT alone. Materials and

Methods: Forty-three lesions from 24 patients were randomly assigned to 2 groups. The PBN-ALA-PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow-band light-emitting diode irradiation (λ = 633 ± 10 nm; 100-200 J/cm). The ALA-PDT group received ALA cream and irradiation only.

Results: At 6 weeks, the PBN-ALA-PDT and ALA-PDT groups achieved complete response (CR) rates of 77.78% (14/18 lesions) and 40% (7/20 lesions), respectively, (p < .05), and 2/18 and 10/20 lesions, respectively, achieved CRs after further treatment; 2.9 ± 0.8 sessions and 3.4 ± 0.7 sessions, respectively, were required for the lesions to achieve CRs. The PBN-ALA-PDT group required fewer treatment sessions and had higher protoporphyrin IX fluorescence levels (p < .05).

Conclusion: Plum-blossom needling may improve the efficacy of ALA-PDT by enhancing ALA delivery for BD treatment.