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Comparative tolerability and efficacy of daylight, conventional, and combination aminolevulinic acid photodynamic therapy for treatment of actinic keratosis

Published:January 19, 2021DOI:https://doi.org/10.1016/j.jaad.2021.01.031
      To the Editor: The drawbacks to photodynamic therapy (PDT) for actinic keratoses (AK) include pain during illumination and patient access to a light source that is approved by the US Food and Drug Administration. To address this, dermatologists are exploring daylight PDT.
      • Wiegell S.R.
      • Haedersdal M.
      • Philipsen P.A.
      • et al.
      Continuous activation of PpIX by daylight is as effective as and less painful than conventional photodynamic therapy for actinic keratoses; a randomized, controlled, single-blinded study.
      Clinical studies in Europe and South America provide initial evidence that daylight exposure is efficacious.
      • Rubel D.M.
      • Spelman L.
      • Murrell D.F.
      • et al.
      Daylight photodynamic therapy with methyl aminolevulinate cream as a convenient, similarly effective, nearly painless alternative to conventional photodynamic therapy in actinic keratosis treatment: a randomized controlled trial.
      ,
      • Grinblat B.
      • Galimberti G.
      • Pantoja G.
      • et al.
      Feasibility of daylight-mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study.
      This randomized, single-blind trial investigated the tolerability and safety of daylight PDT for AK on the face and scalp in Northern California.
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      References

        • Wiegell S.R.
        • Haedersdal M.
        • Philipsen P.A.
        • et al.
        Continuous activation of PpIX by daylight is as effective as and less painful than conventional photodynamic therapy for actinic keratoses; a randomized, controlled, single-blinded study.
        Br J Dermatol. 2008; 158: 740-746
        • Rubel D.M.
        • Spelman L.
        • Murrell D.F.
        • et al.
        Daylight photodynamic therapy with methyl aminolevulinate cream as a convenient, similarly effective, nearly painless alternative to conventional photodynamic therapy in actinic keratosis treatment: a randomized controlled trial.
        Br J Dermatol. 2014; 171: 1164-1171
        • Grinblat B.
        • Galimberti G.
        • Pantoja G.
        • et al.
        Feasibility of daylight-mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study.
        Int J Dermatol. 2016; 55: e488-e493
      1. Common Terminology Criteria for Adverse Events (CTCAE) v5.0. U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 2017 (Available at:)
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        Photodynamic therapy with aminolevulinic acid topical solution and visible blue light in the treatment of multiple actinic keratoses of the face and scalp: investigator-blinded, phase 3, multicenter trials.
        Arch Dermatol. 2004; 140: 41-46