No generalized skin phototoxicity after intravesical application of 5-aminolevulinic acid for fluorescence diagnosis of superficial bladder cancer

• Published in: Urologia internationalis Vol. 64; no. 3; p. 126
• Main Authors: Filbeck, T, Wimmershoff, M B, Pichlmeier, U, Karrer, S, Wieland, W F, Szeimies, R M, Rössler, W
• Format: Journal Article
• Language: English
• Published: Switzerland 2000
• Subjects: Administration, Intravesical; Adult; Aged; Aged, 80 and over; Aminolevulinic Acid - administration & dosage; Aminolevulinic Acid - adverse effects; Dermatitis, Phototoxic - etiology; Female; Fluorescence; Humans; Male; Middle Aged; Photosensitizing Agents - administration & dosage; Photosensitizing Agents - adverse effects; Prospective Studies; Urinary Bladder Neoplasms - diagnosis
• ISSN: 0042-1138
• DOI: 10.1159/000030511

A prospective monocenter open study was carried out to evaluate if generalized phototoxic skin reactions occur after intravesical application of 5-aminolevulinic acid (ALA) for fluorescence diagnosis of superficial bladder carcinomas. On 21 patients, skin phototoxicity was determined prior to as well as 4, 8 and 28 h after intravesical instillation of a 3% ALA solution by exposing small skin areas to a progressively graded series of defined UVA-light doses (n = 9; 5-80 J/cm(2)). Prior to ALA instillation, erythema or pigmentation as signs of cutaneous phototoxicity occurred at an UVA-light dose of 28 +/- 1.5 J/cm(2) (mean +/- SEM). A reduction of the minimal phototoxic dose (MPD) was not detected 4 (28 +/- 1.9 J/cm(2)), 8 (28 +/- 1.6 J/cm(2)) and 28 h (28 +/- 1.5 J/cm(2)) after ALA instillation. Consequently phototoxic reactions were not observed. A reduction of MPD for UVA was not detected. Therefore, it is not necessary to protect the skin of patients from ambient or daylight after intravesical instillation of ALA for fluorescence diagnosis.