A consensus on the use of daylight photodynamic therapy in the UK. (19th May 2017)

• Record Type: Journal Article
• Authors: Ibbotson, Sally; Stones, Robin; Bowling, Jonathan; Campbell, Sandra; Kownacki, Stephen; Sivaramakrishnan, Muthu; Valentine, Ronan; Morton, Colin A.
• Is Part Of: Journal of dermatological treatment. Volume 28:Number 4(2017)
• Page Start: 360
• Page End: 367
• Publication Date: 2017-05-19
• Subjects: Actinic keratosis -- daylight -- methyl aminolevulinate -- photodynamic therapy; Skin -- Diseases -- Treatment -- Periodicals; Skin Diseases -- drug therapy -- Periodicals; Skin Diseases -- therapy -- Periodicals; 616.5
• DOI: 10.1080/09546634.2016.1240863
• Languages: English
• ISSNs: 0954-6634

Abstract

Abstract: Background: Actinic keratoses (AKs) are a consequence of chronic exposure to ultraviolet radiation. Treatment of chronically photo-damaged skin and AKs is driven by risk of progression to squamous cell carcinoma, as well as for symptomatic relief. Conventional photodynamic therapy (c-PDT) is indicated when AKs are multiple or confluent and if patients respond poorly or are unable to tolerate other therapies. c-PDT is limited by the field size that can be treated in single sessions and can cause significant discomfort. Objective: Recent studies investigated daylight illumination to activate protoporphyrin IX and daylight-PDT (d-PDT) is now licensed in the UK for face and scalp AKs. A group of experts met to discuss application of d-PDT with methyl aminolevulinate (MAL) and develop a UK consensus statement, specific to UK weather conditions. Methods: The UK consensus recommendations were reached among eight experts, who reviewed recent studies on d-PDT, assessed UK meteorological data and discussed personal experiences of d-PDT for AKs. Results: Recommendations from these discussions provide guidance on d-PDT use, specifically regarding patient selection, therapeutic indications, when to treat, skin preparation, MAL application and daylight exposure for patients with AKs. Conclusions: This UK expert consensus provides practical guidance for UK application of d-PDT.