Methyl Aminolevulinate in Skin Cancers



Methyl aminolevulinate (MAL) is registered in several countries worldwide not only for PDT of actinic keratoses but also for superficial and nodular basal cell carcinoma (sBCC & nBCC) and Bowen’s disease. In the following chapter, evidence-based data of MAL-PDT for epithelial skin cancer are reviewed and further use of MAL-PDT is discussed. Cure rates for sBCC and nBCC are comparable to that of other nonsurgical procedures, whereas MAL-PDT for Bowen’s disease is as effective as conventional surgery or application of topical 5-FU or cryotherapy, but with much better cosmesis.


Cosmetic Outcome Actinic Keratose Nonmelanoma Skin Cancer Excellent Cosmetic Outcome Mohs Micrographic Surgery 


  1. 1.
    Babilas P, Schreml S, Landthaler M, Szeimies RM. Photodynamic therapy in dermatology: state-of-the-art. Photodermatol Photoimmunol Photomed. 2010;26:118–32.PubMedCrossRefGoogle Scholar
  2. 2.
    Lehmann P. Methyl aminolaevulinate-photodynamic therapy: a review of clinical trials in the treatment of actinic keratoses and nonmelanoma skin cancer. Br J Dermatol. 2007;156:793–801.PubMedCrossRefGoogle Scholar
  3. 3.
    Christensen E, Warloe T, Kroon S, et al. Guidelines for practical use of MAL-PDT in non-melanoma skin cancer. J Eur Acad Dermatol Venereol. 2010;24:505–12.PubMedCrossRefGoogle Scholar
  4. 4.
    Soler AM, Warloe T, Berner A, Giercksky KE. A follow-up study of recurrence and cosmesis in completely responding superficial and nodular basal cell carcinomas treated with methyl 5-aminolaevulinate-based photodynamic therapy alone and with prior curettage. Br J Dermatol. 2001;145:467–71.PubMedCrossRefGoogle Scholar
  5. 5.
    Morton CA, Whitehurst C, McColl JH, et al. Photodynamic therapy for large or multiple patches of Bowen disease and basal cell carcinoma. Arch Dermatol. 2001;137:319–24.PubMedGoogle Scholar
  6. 6.
    Horn M, Wolf P, Wulf HC, et al. Topical methyl aminolaevulinate photodynamic therapy in patients with basal cell carcinoma prone to complications and poor cosmetic outcome with conventional treatment. Br J Dermatol. 2003;149:1242–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Rhodes LE, de Rie M, Enstrom Y, et al. Photodynamic therapy using topical methyl aminolevulinate vs. surgery for nodular basal cell carcinoma: results of a multicenter randomized prospective trial. Arch Dermatol. 2004;140:17–23.PubMedCrossRefGoogle Scholar
  8. 8.
    Wang I, Bendsoe N, Klinteberg CA, et al. Photodynamic therapy vs. cryosurgery of basal cell carcinomas: results of a phase III clinical trial. Br J Dermatol. 2001;144:832–40.PubMedCrossRefGoogle Scholar
  9. 9.
    Basset-Seguin N, Ibbotson SH, Emtestam L, et al. Topical methyl aminolaevulinate photodynamic therapy versus cryotherapy for superficial basal cell carcinoma: a 5 year randomized trial. Eur J Dermatol. 2008;18:547–53.PubMedGoogle Scholar
  10. 10.
    Foley P, Freeman M, Menter A, et al. Photodynamic therapy with methyl aminolevulinate for primary nodular basal cell carcinoma: results of two randomized studies. Int J Dermatol. 2009;48:1236–45.PubMedCrossRefGoogle Scholar
  11. 11.
    Zeitouni NC, Oseroff AR, Shieh S. Photodynamic therapy for nonmelanoma skin cancers. Current review and update. Mol Immunol. 2003;39:1133–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Foley P. Clinical efficacy of methyl aminolevulinate (Metvix) photodynamic therapy. J Dermatolog Treat. 2003;14 Suppl 3:15–22.PubMedGoogle Scholar
  13. 13.
    Szeimies RM, Ibbotson S, Murrell DF, et al. A clinical study comparing methyl aminolevulinate photodynamic therapy and surgery in small superficial basal cell carcinoma (8-20 mm), with a 12-month follow-up. J Eur Acad Dermatol Venereol. 2008;22: 1302–11.PubMedCrossRefGoogle Scholar
  14. 14.
    Caekelbergh K, Nikkels AF, Leroy B, et al. Photodynamic therapy using methyl aminolevulinate in the management of primary superficial basal cell carcinoma: clinical and health economic outcomes. J Drugs Dermatol. 2009;8:992–6.PubMedGoogle Scholar
  15. 15.
    Fai D, Arpaia N, Romano I, et al. Methyl-aminolevulinate photodynamic therapy for the treatment of actinic keratoses and non-melanoma skin cancers: a retrospective analysis of response in 462 patients. G Ital Dermatol Venereol. 2009;144:281–5.PubMedGoogle Scholar
  16. 16.
    Haedersdal M, Sakamoto FH, Farinelli WA, et al. Fractional CO2 laser-assisted drug delivery. Lasers Surg Med. 2010;42:113–22.PubMedCrossRefGoogle Scholar
  17. 17.
    Clementoni MT, Roscher M, Munavalli GS. Photodynamic photorejuvenation of the face with a combination of microneedling, red light, and broadband pulsed light. Lasers Surg Med. 2010;42:150–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Pye A, Campbell S, Curnow A. Enhancement of methyl-aminolevulinate photodynamic therapy by iron chelation with CP94: an in vitro investigation and clinical dose-escalating safety study for the treatment of nodular basal cell carcinoma. J Cancer Res Clin Oncol. 2008;134:841–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Cox NH, Eedy DJ, Morton CA. Guidelines for management of Bowen’s disease: 2006 update. Therapy Guidelines and Audit Subcommittee, British Association of Dermatologists. Br J Dermatol. 2007;156:11–21.PubMedCrossRefGoogle Scholar
  20. 20.
    Braathen LR, Szeimies RM, Basset-Seguin N, et al. Guidelines on the use of photodynamic therapy for nonmelanoma skin cancer: an international ­consensus. International Society for Photodynamic Therapy in Dermatology, 2005. J Am Acad Dermatol. 2007;56:125–43.PubMedCrossRefGoogle Scholar
  21. 21.
    Morton CA, McKenna KE. British Association of Dermatologists Therapy Guidelines and Audit Subcommittee and the British Photodermatology Group. Guidelines for topical photodynamic therapy: update. Br J Dermatol. 2008;159:1245–66.PubMedCrossRefGoogle Scholar
  22. 22.
    Morton C, Horn M, Leman J, et al. Comparison of topical methyl aminolevulinate photodynamic therapy with cryotherapy or Fluorouracil for treatment of squamous cell carcinoma in situ: results of a multicenter randomized trial. Arch Dermatol. 2006;142:729–35.PubMedCrossRefGoogle Scholar
  23. 23.
    Morton CA. Methyl aminolevulinate: actinic keratoses and Bowen’s disease. Dermatol Clin. 2007;25:81–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Calzavara-Pinton PG, Venturini M, Sala R, et al. Methylaminolaevulinate-based photodynamic therapy of Bowen’s disease and squamous cell carcinoma. Br J Dermatol. 2008;159:137–44.PubMedCrossRefGoogle Scholar
  25. 25.
    Zane C, Venturini M, Sala R, Calzavara-Pinton P. Photodynamic therapy with methylaminolevulinate as a valuable treatment option for unilesional cutaneous T-cell lymphoma. Photodermatol Photoimmunol Photomed. 2006;22:254–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Dermatology and AllergologyKlinikum Vest Academic Teaching HospitalRecklinghausenGermany
  2. 2.Department of DermatologyRegensburg University HospitalRegensburgGermany

Personalised recommendations