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A skin safety test performed in the United States showed that 52% of a group of 58 healthy volunteers became sensitized after exposure to MAL cream applied to the back under occlusion.7 The use of PDT in patients with nonsegmental Darier disease has been reported in 3 cases.810Exadaktylou et al.8 reported 5 cases treated with ALA-PDT
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The result is a synergistic pulse that is significantly larger than either peptide alone, while still being a physiological pulse rather than a pharmacological spike
Topical glutathione has shown good short-term safety
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