Photodynamic Therapy (PDT) With Levulan and Blue Light for the Treatment of Actinic Cheilitis

The study will consist of a screening visit, up to three scheduled treatments, and two
scheduled office visits. There can be a three-day window period for each scheduled visit in
order to accommodate the subject's schedule and unforeseen scheduling conflicts.

1. Visit 1 (Screening): Subjects can be screened for the study up to two weeks before Visit
2 (Baseline). During screening, the study will be reviewed, written informed consent
obtained, and eligibility confirmed. If applicable, the washout from prohibited
medications or treatments will be determined at this visit.

2. Visit 2 (Baseline): Following signed, written informed consent and confirmation of
eligibility, all subjects will have their lips photographed. Medical history,
dermatologic exam, urine pregnancy test (if applicable), review of concomitant
medications, clinical evaluations, and tolerability assessments will be performed at
this visit. Study medication application to clean skin will be followed by a 90 minute
incubation period under occlusion. Subsequently, patients will be exposed to blue light
therapy for 16 minutes and 40 seconds. Post-therapy assessments will be performed
afterwards, as well as education on appropriate sun protection methods.

3. Visits 3-4: Subjects will return every six weeks for up to two additional treatments.
Treatment will be discontinued once the patient has achieved clinical clearance.
Tolerability assessments, study medication application, blue light therapy, post-therapy
assessments, and photographs will be performed.

4. Visit 5-6 (End of Study): Subjects will return 12 and 24 weeks after the last treatment
for clinical evaluations, tolerability assessments, and photographs.

Inclusion Criteria:

- Must be able to understand and voluntarily sign an informed consent form

- Must be male or female ≥ 18 years of age at the time of consent

- Must be able to adhere to the study visit schedule and other protocol requirements

- Must have a diagnosis of actinic cheilitis by histopathological evaluation of biopsy
specimen or clinical presentation

Exclusion Criteria:

- Inability to provide voluntarily consent or mentally incompetent

- Active herpes labialis lesions

- Subjects with any condition which places the subject at unacceptable risk if he/she
were to participate in the study, or confounds the ability to interpret data from the
study

- Subjects with any other skin condition that might affect the evaluation of the study
disease

- Pregnant or breastfeeding female subjects

- Subjects who have used any investigational medication within one month prior to study
entry

- Subjects who have been previously exposed to PDT and/or topical Levulan therapy for
the treatment of actinic cheilitis

- Subjects who have used local therapy (e.g. cryotherapy) or topical treatment (e.g. 5%
fluorouracil) within three months of study entry

- Subjects who have used an oral photosensitizing drug (e.g. Declomycin) within six
months of study entry

- Subjects who are currently using photosensitizing agents (e.g. thiazides,
tetracyclines, fluoroquinolones, phenothiazines, and sulfonamides) because of the risk
of augmented photosensitivity

- Subjects who are frequently exposed to ultraviolet radiation (e.g. lifeguards,
construction workers, frequent sunbed users, etc.)

- Subjects with a history of cutaneous photosensitization, porphyria, hypersensitivity
to porphyrins, or photodermatosis

- Subjects with a known hypersensitivity to Levulan

- Subjects who are immunocompromised