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Research Letter |

Comparative Methods for Improving Transepidermal Methylaminolevulinate Delivery A Randomized Clinical Trial

Philippe Bahadoran, MD, PhD1,2; Florence Le Duff, MD1,2; Thierry Pascual, MS3; Laurent Petit, PhD3; Philippe Martel, MD, PhD3; Jean-Philippe Lacour, MD1; Thierry Passeron, MD, PhD1,4
[+] Author Affiliations
1Department of Dermatology, University Hospital of Nice, Nice, France
2Centre de Recherche Clinique, University Hospital of Nice, Nice, France
3Galderma Research & Development, Clinical Unit for Tests and Imaging of Skin, Sophia Antipolis, France
4Institut National de la Santé Et de la Recherche Médicale U1065, Team 12, C3M, University Hospital of Nice, Nice, France
JAMA Dermatol. 2015;151(12):1371-1373. doi:10.1001/jamadermatol.2015.2234.
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This randomized clinical trial evaluates the use of laser vs microneedle transepidermal administration of methylaminolevulinate.

Penetration through the skin barrier is well known to be a challenge in the development of new drug formulations. Microneedling and ablative fractional lasers are reported13 to have a positive effect on skin penetration and increase of 5-aminolevulininc acid and methylaminolevulinate uptake but, to our knowledge, these methods have never been compared with each other. Fewer data exist concerning the potential interest of using occlusion for enhancing 5-aminolevulininc acid or methylaminolevulinate uptake. A multicenter prospective study4 using blue-light 5-aminolevulininc acid photodynamic therapy suggested that occlusion could increase the efficacy of the procedure. Although the therapeutic interest of using pretreatment for enhancing drug penetration into the skin is now clearly demonstrated, at least for photodynamic therapy, the relative effectiveness and tolerance of available procedures remains unknown.

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Figure 1.
CONSORT Flow Diagram
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Figure 2.
Evaluation of Fluorescence in the Skin

Values of fluorescence using the 405-nm probe (A), the 632-nm probe (B), and as measured by the photo camera (C). Laser refers to the fractional ablative carbon dioxide laser. The horizontal line in the box indicates median; the box, interquartile range; error bars, minimum and maximum values; and open circles, eventual outliers.

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