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  Methyl aminolevulinate

Methyl aminolevulinate (MAL) is a prodrug that is metabolised to Protoporphyrin IX (sensitizer) used in photodynamic therapy. It is marketed as Metvix. Metvix cream is applied topically and some time later the skin is illuminated with a proprietary red light (630 nm) source (medical lamp 'Aktilite') to activate the photosensitiser. Metvix is developed by Photocure and Galderma has bought all rights to Metvix. Methyl aminolevulinate was approved in New Zealand for treatment of basal cell carcinoma, It is now approved in many countries and has been used to treat non-melanoma skin cancer (including basal cell carcinoma). It has some advantages over Levulan (source: http://en.wikipedia.org/wiki/Methyl_aminolevulinate). .

methyl-5-aminolevulinate hydrochloride cream is a topical cream formulation containing the hydrochloride salt of methyl-5-aminolevulinate, a lipophilic methyl ester of 5-aminolevulinic acid, with photosensitizer prodrug activity. Upon topical administration, methyl-5-aminolevulinate in the cream is selectively absorbed by tumor cells where it is converted to the photosensitizer protoporphyrin IX (PpIX). Upon photoirradiation, PpIX is activated and transfers energy to oxygen, generating singlet oxygen and superoxide and hydroxyl radicals, which may result in free-radical-mediated DNA damage and cell death. Check for active clinical trials or closed clinical trials using this agent. (NCI Thesaurus).

Current developer:    PhotoCure

1: Devirgiliis V, Panasiti V, Fioriti D, Anzivino E, Bellizzi A, Cimillo M, Curzio M, Melis L, Roberti V, Gobbi S, Liteo P, Richetta AG, Calvieri S, Chiarini F, Nicosia R, Pietropaolo V. Antibacterial activity of methyl aminolevulinate photodynamic therapy in the treatment of a cutaneous ulcer. Int J Immunopathol Pharmacol. 2011 Jul-Sep;24(3):793-5. PubMed PMID: 21978711.

2: Haedersdal M, Katsnelson J, Sakamoto FH, Farinelli WA, Doukas AG, Tam J, Anderson RR. Enhanced uptake and photoactivation of topical methyl aminolevulinate after fractional CO2 laser pretreatment. Lasers Surg Med. 2011 Sep;43(8):804-13. doi: 10.1002/lsm.21096. PubMed PMID: 21956628.

3: Fai D, Romano I, Cassano N, Vena GA. Methyl-aminolevulinate photodynamic therapy for the treatment of erythroplasia of Queyrat in 23 patients. J Dermatolog Treat. 2011 Sep 4. [Epub ahead of print] PubMed PMID: 21888568.

4: Antonia Pastor-Nieto M, Olivares M, Sánchez-Herreros C, Belmar P, De Eusebio E. Occupational allergic contact dermatitis from methyl aminolevulinate. Dermatitis. 2011 Aug 1;22(4):216-9. PubMed PMID: 21781638.

5: Pauwels C, Mazereeuw-Hautier J, Basset-Seguin N, Livideanu C, Viraben R, Paul C, Meyer N. Topical methyl aminolevulinate photodynamic therapy for management of basal cell carcinomas in patients with basal cell nevus syndrome improves patient's satisfaction and reduces the need for surgical procedures. J Eur Acad Dermatol Venereol. 2011 Jul;25(7):861-4. doi: 10.1111/j.1468-3083.2010.03854.x. Epub 2010 Oct 3. PubMed PMID: 21668511.

6: Kitagawa KH, Bogner P, Zeitouni NC. Photodynamic therapy with methyl-aminolevulinate for the treatment of double extramammary Paget's disease. Dermatol Surg. 2011 Jul;37(7):1043-6. doi: 10.1111/j.1524-4725.2011.02039.x. Epub 2011 Jun 1. PubMed PMID: 21631634.

7: Tierney E, Petersen J, Hanke CW. Photodynamic diagnosis of tumor margins using methyl aminolevulinate before Mohs micrographic surgery. J Am Acad Dermatol. 2011 May;64(5):911-8. PubMed PMID: 21496702.

8: Lee JW, Lee HI, Kim MN, Kim BJ, Chun YJ, Kim D. Topical photodynamic therapy with methyl aminolevulinate may be an alternative therapeutic option for the recalcitrant Malassezia folliculitis. Int J Dermatol. 2011 Apr;50(4):488-90. doi: 10.1111/j.1365-4632.2009.04377.x. PubMed PMID: 21413966.

9: Tyrrell J, Campbell SM, Curnow A. Monitoring the accumulation and dissipation of the photosensitizer protoporphyrin IX during standard dermatological methyl-aminolevulinate photodynamic therapy utilizing non-invasive fluorescence imaging and quantification. Photodiagnosis Photodyn Ther. 2011 Mar;8(1):30-8. Epub 2010 Dec 17. PubMed PMID: 21333932.

10: Ballester I, Belinchón I, Guijarro J, Oltra F, Toledo F, Cuesta L. Photodynamic therapy of vulvar intraepithelial neoplasia using methyl aminolevulinate. J Dermatolog Treat. 2011 Jan 22. [Epub ahead of print] PubMed PMID: 21254852.

11: Palm MD, Goldman MP. Safety and efficacy comparison of blue versus red light sources for photodynamic therapy using methyl aminolevulinate in photodamaged skin. J Drugs Dermatol. 2011 Jan;10(1):53-60. PubMed PMID: 21197524.

12: Nie Z, Bayat A, Behzad F, Rhodes LE. Positive response of a recurrent keloid scar to topical methyl aminolevulinate-photodynamic therapy. Photodermatol Photoimmunol Photomed. 2010 Dec;26(6):330-2. PubMed PMID: 21140993.

13: Tyrrell J, Campbell S, Curnow A. Protoporphyrin IX photobleaching during the light irradiation phase of standard dermatological methyl-aminolevulinate photodynamic therapy. Photodiagnosis Photodyn Ther. 2010 Dec;7(4):232-8. Epub 2010 Nov 5. PubMed PMID: 21112545.

14: Valentine RM, Ibbotson SH, Brown CT, Wood K, Moseley H. A quantitative comparison of 5-aminolaevulinic acid- and methyl aminolevulinate-induced fluorescence, photobleaching and pain during photodynamic therapy. Photochem Photobiol. 2011 Jan-Feb;87(1):242-9. doi: 10.1111/j.1751-1097.2010.00829.x. Epub 2010 Nov 15. PubMed PMID: 21077899.

15: Wilson EC. Cost effectiveness of imiquimod 5% cream compared with methyl aminolevulinate-based photodynamic therapy in the treatment of non-hyperkeratotic, non-hypertrophic actinic (solar) keratoses: a decision tree model. Pharmacoeconomics. 2010 Nov 1;28(11):1055-64. doi: 10.2165/11538670-000000000-00000. PubMed PMID: 20936887.

16: Tyrrell JS, Campbell SM, Curnow A. The relationship between protoporphyrin IX photobleaching during real-time dermatological methyl-aminolevulinate photodynamic therapy (MAL-PDT) and subsequent clinical outcome. Lasers Surg Med. 2010 Sep;42(7):613-9. PubMed PMID: 20806386.

17: Debu A, Girard C, Kluger N, Guillot B, Dereure O. INTEREST OF TOPICAL METHYL AMINOLEVULINATE PHOTODYNAMIC THERAPY IN EROSIVE FACIAL MYCOSIS FUNGOIDES. Br J Dermatol. 2010 Jun 9. [Epub ahead of print] PubMed PMID: 20545679.

18: Fernández-Guarino M, Harto A, Jaén P. [Studies of methyl aminolevulinate photodynamic therapy for actinic keratosis]. Actas Dermosifiliogr. 2010 May;101(4):315-22. Review. Spanish. PubMed PMID: 20487686.

19: Sebaratnam DF, Venugopal SS, Murrell DF. A comparison in real clinical practice of methyl aminolevulinate photodynamic therapy and surgery for small superficial basal cell carcinoma: 3-year recurrence rates and cosmetic outcomes. J Eur Acad Dermatol Venereol. 2011 Jan;25(1):117-8. doi: 10.1111/j.1468-3083.2010.03697.x. PubMed PMID: 20456551.

20: Aguilar M, de Troya M, Martin L, Benítez N, González M. A cost analysis of photodynamic therapy with methyl aminolevulinate and imiquimod compared with conventional surgery for the treatment of superficial basal cell carcinoma and Bowen's disease of the lower extremities. J Eur Acad Dermatol Venereol. 2010 Dec;24(12):1431-6. doi: 10.1111/j.1468-3083.2010.03664.x. PubMed PMID: 20456549.

21: Sanclemente G, Medina L, Villa JF, Barrera LM, Garcia HI. A prospective split-face double-blind randomized placebo-controlled trial to assess the efficacy of methyl aminolevulinate + red-light in patients with facial photodamage. J Eur Acad Dermatol Venereol. 2011 Jan;25(1):49-58. doi: 10.1111/j.1468-3083.2010.03687.x. PubMed PMID: 20456545.

22: Parera E, Gallardo F, Toll A, Gil I, Sánchez-Schmidt J, Pujol R. Inflammatory linear verrucous epidermal nevus successfully treated with methyl-aminolevulinate photodynamic therapy. Dermatol Surg. 2010 Feb;36(2):253-6. PubMed PMID: 20402956.

23: Yoo KH, Lee JW, Li K, Kim BJ, Kim MN. Photodynamic therapy with methyl 5-aminolevulinate acid might be ineffective in recalcitrant alopecia totalis regardless of using a microneedle roller to increase skin penetration. Dermatol Surg. 2010 May;36(5):618-22. Epub 2010 Apr 2. PubMed PMID: 20384755.

24: Foley P, Freeman M, Menter A, Siller G, El-Azhary RA, Gebauer K, Lowe NJ, Jarratt MT, Murrell DF, Rich P, Pariser DM, Oseroff AR, Barnetson R, Anderson C, Kossard S, Gibson LE, Tope WD. Photodynamic therapy with methyl aminolevulinate for primary nodular basal cell carcinoma: results of two randomized studies. Int J Dermatol. 2009 Nov;48(11):1236-45. PubMed PMID: 20064185.

25: Issa MC, Piñeiro-Maceira J, Vieira MT, Olej B, Mandarim-de-Lacerda CA, Luiz RR, Manela-Azulay M. Photorejuvenation with topical methyl aminolevulinate and red light: a randomized, prospective, clinical, histopathologic, and morphometric study. Dermatol Surg. 2010;36(1):39-48. Epub 2009 Dec 4. PubMed PMID: 20002646.

26: Caekelbergh K, Nikkels AF, Leroy B, Verhaeghe E, Lamotte M, Vincent R. Photodynamic therapy using methyl aminolevulinate in the management of primary superficial basal cell carcinoma: clinical and health economic outcomes. J Drugs Dermatol. 2009 Nov;8(11):992-6. PubMed PMID: 19894366.

27: Lee JW, Yoo KH, Kim BJ, Kim MN. Photodynamic therapy with methyl 5-aminolevulinate acid combined with microneedle treatment in patients with extensive alopecia areata. Clin Exp Dermatol. 2010 Jul;35(5):548-9. Epub 2009 Nov 3. PubMed PMID: 19886963.

28: Kleinpenning MM, van de Kerkhof PC, Gerritsen RM. The clinical efficacy of topical methyl-aminolevulinate photodynamic therapy in moderate to severe actinic keratoses of the face and scalp. J Dermatolog Treat. 2010 Jul;21(4):252-7. PubMed PMID: 19832288.

29: Hörfelt C, Stenquist B, Halldin CB, Ericson MB, Wennberg AM. Single low-dose red light is as efficacious as methyl-aminolevulinate--photodynamic therapy for treatment of acne: clinical assessment and fluorescence monitoring. Acta Derm Venereol. 2009;89(4):372-8. PubMed PMID: 19688149.

30: Chong WS, Kang GY. Dramatic clearance of a recalcitrant acral viral wart using methyl aminolevulinate-red light photodynamic therapy. Photodermatol Photoimmunol Photomed. 2009 Aug;25(4):225-6. PubMed PMID: 19614904.

31: Lesar A, Ferguson J, Moseley H. A time course investigation of the fluorescence induced by topical application of 5-aminolevulinic acid and methyl aminolevulinate on normal human skin. Photodermatol Photoimmunol Photomed. 2009 Aug;25(4):191-5. PubMed PMID: 19614897.

32: Ortiz-Policarpio B, Lui H. Methyl aminolevulinate-PDT for actinic keratoses and superficial nonmelanoma skin cancers. Skin Therapy Lett. 2009 Jul-Aug;14(6):1-3. Review. PubMed PMID: 19609473.

33: Fai D, Arpaia N, Romano I, Vestita M, Cassano N, Vena GA. 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 Jun;144(3):281-5. PubMed PMID: 19528909.

34: Braathen LR, Paredes BE, Saksela O, Fritsch C, Gardlo K, Morken T, Frølich KW, Warloe T, Solér AM, Ros AM. Short incubation with methyl aminolevulinate for photodynamic therapy of actinic keratoses. J Eur Acad Dermatol Venereol. 2009 May;23(5):550-5. PubMed PMID: 19415804.

35: Szeimies RM, Matheson RT, Davis SA, Bhatia AC, Frambach Y, Klövekorn W, Fesq H, Berking C, Reifenberger J, Thaçi D. Topical methyl aminolevulinate photodynamic therapy using red light-emitting diode light for multiple actinic keratoses: a randomized study. Dermatol Surg. 2009 Apr;35(4):586-92. Epub 2009 Mar 3. PubMed PMID: 19309347.

36: Puccioni M, Santoro N, Giansanti F, Ucci F, Rossi R, Lotti T, Menchini U. Photodynamic therapy using methyl aminolevulinate acid in eyelid basal cell carcinoma: a 5-year follow-up study. Ophthal Plast Reconstr Surg. 2009 Mar-Apr;25(2):115-8. PubMed PMID: 19300153.

37: Gilaberte Y, Frias MP, Rezusta A, Vera-Alvarez J. Photodynamic therapy with methyl aminolevulinate for resistant scalp folliculitis secondary to Demodex infestation. J Eur Acad Dermatol Venereol. 2009 Jun;23(6):718-9. Epub 2009 Feb 24. PubMed PMID: 19298484.

38: Fernández-Guarino M, Harto A, Sánchez-Ronco M, Pérez-García B, Marquet A, Jaén P. [Retrospective, descriptive, observational study of treatment of multiple actinic keratoses with topical methyl aminolevulinate and red light: results in clinical practice and correlation with fluorescence imaging]. Actas Dermosifiliogr. 2008 Dec;99(10):779-87. Spanish. PubMed PMID: 19091216.

39: Pariser D, Loss R, Jarratt M, Abramovits W, Spencer J, Geronemus R, Bailin P, Bruce S. Topical methyl-aminolevulinate photodynamic therapy using red light-emitting diode light for treatment of multiple actinic keratoses: A randomized, double-blind, placebo-controlled study. J Am Acad Dermatol. 2008 Oct;59(4):569-76. Epub 2008 Aug 15. PubMed PMID: 18707799.

40: Wennberg AM, Stenquist B, Stockfleth E, Keohane S, Lear JT, Jemec G, Mork C, Christensen E, Kapp A, Solvsten H, Talme T, Berne B, Forschner T. Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study. Transplantation. 2008 Aug 15;86(3):423-9. PubMed PMID: 18698246.

41: Annemans L, Caekelbergh K, Roelandts R, Boonen H, Leys C, Nikkels AF, van Den Haute V, van Quickenborne L, Verhaeghe E, Leroy B. Real-life practice study of the clinical outcome and cost-effectiveness of photodynamic therapy using methyl aminolevulinate (MAL-PDT) in the management of actinic keratosis and basal cell carcinoma. Eur J Dermatol. 2008 Sep-Oct;18(5):539-46. Epub 2008 Aug 8. PubMed PMID: 18693157.

42: Ruiz-Rodríguez R, López L, Candelas D, Pedraz J. Photorejuvenation using topical 5-methyl aminolevulinate and red light. J Drugs Dermatol. 2008 Jul;7(7):633-7. PubMed PMID: 18664154.

43: Szeimies RM, Ibbotson S, Murrell DF, Rubel D, Frambach Y, de Berker D, Dummer R, Kerrouche N, Villemagne H; Excilight Study Group. 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 Nov;22(11):1302-11. Epub 2008 Jul 2. PubMed PMID: 18624836.

44: de Bruijn HS, Meijers C, van der Ploeg-van den Heuvel A, Sterenborg HJ, Robinson DJ. Microscopic localisation of protoporphyrin IX in normal mouse skin after topical application of 5-aminolevulinic acid or methyl 5-aminolevulinate. J Photochem Photobiol B. 2008 Aug 21;92(2):91-7. Epub 2008 May 15. PubMed PMID: 18571933.

45: Toll A, Parera ME, Vélez M, Pujol RM. Letter: photodynamic therapy with methyl aminolevulinate induces phototoxic reactions on areas of the nose adjacent to basal cell carcinomas and actinic keratoses. Dermatol Surg. 2008 Aug;34(8):1145-7; discussion 1147-8. Epub 2008 Jun 2. PubMed PMID: 18518890.

46: Hegyi J, Frey T, Arenberger P. The treatment of unilesional mycosis fungoides with methyl aminolevulinate-photodynamic therapy. J Eur Acad Dermatol Venereol. 2008 Sep;22(9):1134-5. Epub 2008 Feb 4. PubMed PMID: 18266688.

47: 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 Aug;134(8):841-9. Epub 2008 Feb 1. PubMed PMID: 18239941.

48: Gold MH. 5-Aminolevulinic acid photodynamic therapy versus methyl aminolevulinate photodynamic therapy for inflammatory acne vulgaris. J Am Acad Dermatol. 2008 Feb;58(2 Suppl):S60-2. PubMed PMID: 18191717.

49: Campbell SM, Pye A, Horton S, Matthew J, Helliwell P, Curnow A. A clinical investigation to determine the effect of pressure injection on the penetration of topical methyl aminolevulinate into nodular basal cell carcinoma of the skin. J Environ Pathol Toxicol Oncol. 2007;26(4):295-303. PubMed PMID: 18197827.

50: de Bruijn HS, de Haas ER, Hebeda KM, van der Ploeg-van den Heuvel A, Sterenborg HJ, Neumann HA, Robinson DJ. Light fractionation does not enhance the efficacy of methyl 5-aminolevulinate mediated photodynamic therapy in normal mouse skin. Photochem Photobiol Sci. 2007 Dec;6(12):1325-31. Epub 2007 Aug 28. PubMed PMID: 18046489.

51: Hohwy T, Andersen KE, Sølvsten H, Sommerlund M. Allergic contact dermatitis to methyl aminolevulinate after photodynamic therapy in 9 patients. Contact Dermatitis. 2007 Nov;57(5):321-3. PubMed PMID: 17937747.

52: Bender J, Jarvoll P, Nydén M, Engström S. Structure and dynamics of a sponge phase in the methyl delta-aminolevulinate/monoolein/water/propylene glycol system. J Colloid Interface Sci. 2008 Jan 15;317(2):577-84. Epub 2007 Sep 25. PubMed PMID: 17936774.

53: Rhodes LE, de Rie MA, Leifsdottir R, Yu RC, Bachmann I, Goulden V, Wong GA, Richard MA, Anstey A, Wolf P. Five-year follow-up of a randomized, prospective trial of topical methyl aminolevulinate photodynamic therapy vs surgery for nodular basal cell carcinoma. Arch Dermatol. 2007 Sep;143(9):1131-6. PubMed PMID: 17875873.

54: Axcrona K, Brennhovd B, Alfsen GC, Giercksky KE, Warloe T. Photodynamic therapy with methyl aminolevulinate for atypial carcinoma in situ of the penis. Scand J Urol Nephrol. 2007;41(6):507-10. PubMed PMID: 17853049.

55: Surrenti T, De Angelis L, Di Cesare A, Fargnoli MC, Peris K. Efficacy of photodynamic therapy with methyl aminolevulinate in the treatment of superficial and nodular basal cell carcinoma: an open-label trial. Eur J Dermatol. 2007 Sep-Oct;17(5):412-5. Epub 2007 Aug 2. PubMed PMID: 17673385.

56: Horn M, Wolf P. Topical methyl aminolevulinate photodynamic therapy for the treatment of folliculitis. Photodermatol Photoimmunol Photomed. 2007 Aug;23(4):145-7. PubMed PMID: 17598868.

57: Pye A, Curnow A. Direct comparison of delta-aminolevulinic acid and methyl-aminolevulinate-derived protoporphyrin IX accumulations potentiated by desferrioxamine or the novel hydroxypyridinone iron chelator CP94 in cultured human cells. Photochem Photobiol. 2007 May-Jun;83(3):766-73. PubMed PMID: 17576385.

58: Harries MJ, Street G, Gilmour E, Rhodes LE, Beck MH. Allergic contact dermatitis to methyl aminolevulinate (Metvix) cream used in photodynamic therapy. Photodermatol Photoimmunol Photomed. 2007 Feb;23(1):35-6. PubMed PMID: 17254035.

59: Szeimies RM. Methyl aminolevulinate-photodynamic therapy for basal cell carcinoma. Dermatol Clin. 2007 Jan;25(1):89-94. Review. PubMed PMID: 17126746.

60: Morton CA. Methyl aminolevulinate: actinic keratoses and Bowen's disease. Dermatol Clin. 2007 Jan;25(1):81-7. Review. PubMed PMID: 17126745.

61: Ma L, Steindal AE, Juzeniene A, Iani V, Moan J. The effect of folic acid on porphyrin synthesis in tumors and normal skin of mice treated with 5-aminolevulinic acid or methyl 5-aminolevulinate. Photochem Photobiol Sci. 2006 Aug;5(8):755-9. Epub 2006 Jun 14. PubMed PMID: 16886091.

62: Kuijpers DI, Thissen MR, Thissen CA, Neumann MH. Similar effectiveness of methyl aminolevulinate and 5-aminolevulinate in topical photodynamic therapy for nodular basal cell carcinoma. J Drugs Dermatol. 2006 Jul-Aug;5(7):642-5. PubMed PMID: 16865869.

63: Cavicchini S, Tourlaki A. Successful treatment of disseminated superficial actinic porokeratosis with methyl aminolevulinate-photodynamic therapy. J Dermatolog Treat. 2006;17(3):190-1. PubMed PMID: 16854765.

64: Perrett CM, McGregor J, Barlow RJ, Karran P, Proby C, Harwood CA. Topical photodynamic therapy with methyl aminolevulinate to treat sebaceous hyperplasia in an organ transplant recipient. Arch Dermatol. 2006 Jun;142(6):781-2. PubMed PMID: 16785387.

65: Morton C, Horn M, Leman J, Tack B, Bedane C, Tjioe M, Ibbotson S, Khemis A, Wolf P. 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 Jun;142(6):729-35. PubMed PMID: 16785375.

66: Kasche A, Luderschmidt S, Ring J, Hein R. Photodynamic therapy induces less pain in patients treated with methyl aminolevulinate compared to aminolevulinic acid. J Drugs Dermatol. 2006 Apr;5(4):353-6. PubMed PMID: 16673803.

67: Wiegell SR, Wulf HC. Photodynamic therapy of acne vulgaris using 5-aminolevulinic acid versus methyl aminolevulinate. J Am Acad Dermatol. 2006 Apr;54(4):647-51. PubMed PMID: 16546587.

68: Angell-Petersen E, Sørensen R, Warloe T, Soler AM, Moan J, Peng Q, Giercksky KE. Porphyrin formation in actinic keratosis and basal cell carcinoma after topical application of methyl 5-aminolevulinate. J Invest Dermatol. 2006 Feb;126(2):265-71. PubMed PMID: 16374471.

69: Hauschild A, Lischner S, Lange-Asschenfeldt B, Egberts F. Treatment of actinic cheilitis using photodynamic therapy with methyl aminolevulinate: report of three cases. Dermatol Surg. 2005 Oct;31(10):1344-7, discussion 1348. PubMed PMID: 16188193.

70: Tarstedt M, Rosdahl I, Berne B, Svanberg K, Wennberg AM. A randomized multicenter study to compare two treatment regimens of topical methyl aminolevulinate (Metvix)-PDT in actinic keratosis of the face and scalp. Acta Derm Venereol. 2005;85(5):424-8. PubMed PMID: 16159735.

71: Lee MR, Ryman W. Erythroplasia of Queyrat treated with topical methyl aminolevulinate photodynamic therapy. Australas J Dermatol. 2005 Aug;46(3):196-8. PubMed PMID: 16008656.

72: Weston A, Fitzgerald P. Discrete choice experiment to derive willingness to pay for methyl aminolevulinate photodynamic therapy versus simple excision surgery in basal cell carcinoma. Pharmacoeconomics. 2004;22(18):1195-208. PubMed PMID: 15606226.

73: Siddiqui MA, Perry CM, Scott LJ. Topical methyl aminolevulinate. Am J Clin Dermatol. 2004;5(2):127-37; discussion 138-40. Review. PubMed PMID: 15109276.

74: Rhodes LE, de Rie M, Enström Y, Groves R, Morken T, Goulden V, Wong GA, Grob JJ, Varma S, Wolf P. Photodynamic therapy using topical methyl aminolevulinate vs surgery for nodular basal cell carcinoma: results of a multicenter randomized prospective trial. Arch Dermatol. 2004 Jan;140(1):17-23. PubMed PMID: 14732655.

75: Morton CA. Methyl aminolevulinate (Metvix) photodynamic therapy - practical pearls. J Dermatolog Treat. 2003;14 Suppl 3:23-6. Review. PubMed PMID: 14522638.

76: Foley P. Clinical efficacy of methyl aminolevulinate (Metvix) photodynamic therapy. J Dermatolog Treat. 2003;14 Suppl 3:15-22. Review. PubMed PMID: 14522637.

77: Brown SB. The role of light in the treatment of non-melanoma skin cancer using methyl aminolevulinate. J Dermatolog Treat. 2003;14 Suppl 3:11-4. Review. PubMed PMID: 14522636.

78: Freeman M, Vinciullo C, Francis D, Spelman L, Nguyen R, Fergin P, Thai KE, Murrell D, Weightman W, Anderson C, Reid C, Watson A, Foley P. A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study. J Dermatolog Treat. 2003 Jun;14(2):99-106. PubMed PMID: 12775317.

79: Pariser DM, Lowe NJ, Stewart DM, Jarratt MT, Lucky AW, Pariser RJ, Yamauchi PS. Photodynamic therapy with topical methyl aminolevulinate for actinic keratosis: results of a prospective randomized multicenter trial. J Am Acad Dermatol. 2003 Feb;48(2):227-32. PubMed PMID: 12582393.

80: Szeimies RM, Karrer S, Radakovic-Fijan S, Tanew A, Calzavara-Pinton PG, Zane C, Sidoroff A, Hempel M, Ulrich J, Proebstle T, Meffert H, Mulder M, Salomon D, Dittmar HC, Bauer JW, Kernland K, Braathen L. Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: A prospective, randomized study. J Am Acad Dermatol. 2002 Aug;47(2):258-62. PubMed PMID: 12140473.

81: Sharfaei S, Juzenas P, Moan J, Bissonnette R. Weekly topical application of methyl aminolevulinate followed by light exposure delays the appearance of UV-induced skin tumours in mice. Arch Dermatol Res. 2002 Jul;294(5):237-42. Epub 2002 Jun 26. PubMed PMID: 12115027.

82: Peng Q, Soler AM, Warloe T, Nesland JM, Giercksky KE. Selective distribution of porphyrins in skin thick basal cell carcinoma after topical application of methyl 5-aminolevulinate. J Photochem Photobiol B. 2001 Sep 15;62(3):140-5. PubMed PMID: 11566277.