Demonstration of protoporphyrin IX (PpIX) localized to areas of palmar skin injected with 5-aminolevulinic acid (ALA) and pre-treated with a fractionated CO₂ laser prior to topically applied ALA☆

Summary 

Background

Several techniques designed to enhance ALA delivery into subcorneal layers of palmar skin are described.

Methods

Six palms from three subjects were treated with topical ALA, iontophoresis enhanced delivery of ALA, intradermal injections of ALA solution, or fractionated CO₂ laser (with or without erbium:YAG surface ablation). The relative efficacy of each technique was determined using Wood's lamp illumination for the presence of fluorescent PpIX.

Results

Palms treated with topically applied ALA alone or with iontophoresis pre-treatment failed to exhibit fluorescence. The palm treated with intradermal injections of ALA and the palms pre-treated with fractionated CO₂ laser with or without erbium:YAG laser surface ablation exhibited fluorescence at treatment areas.

Conclusion

Both intradermal injections and fractionated CO₂ laser (with or without erbium:YAG laser pre-treatment) may provide an effective means for delivery of ALA into subcorneal layers of palmar skin. Numerous potential clinical applications of these techniques (including treatment of localized palmar hyperhidrosis) exist.

Keywords: Aminolevulinic acid, Delivery system, Intradermal injection, Iontophoresis, Fractionated CO₂ laser, Palms