Long-term efficacy and safety of daylight photodynamic therapy with methyl amninolevulinate for actinic keratosis of the face and scalp

Daylight photodynamic therapy with methyl aminolevulinate cream is as effective as conventional photodynamic therapy with blue light in the treatment of actinic keratosis: a controlled randomized intra‐individual study

“…In 2015, Fargnoli et al 13 found a recurrence rate after 6 months of 17% and 12% with DL-PDT and c-PDT, respectively, with a statistical difference that was not further reported in the long-term results in 2017 after 12 months: 13% vs. 10%, respectively, with no statistical difference. 12 On the other hand, this study confirms that DL-PDT is less painful than c-PDT, even with blue light (pain score: 5.1 AE 2.1 vs. 1.2 AE 1.9 for DL-PDT and c-PDT respectively, P < 0.0001). Continuous production and activation of PpIXfor 2 h with DL-PDT could explain the better pain tolerance.…”

“…A few studies (comparing daylight to red light) involved follow‐ups for up to 6 or even 12 months . Our study showed that the response was maintained at 6 months, with a reduction of more than 90% when using DL‐PDT.…”

“…Several randomized studies have proven the non-inferiority of DL-PDT vs. PDT with red light. 2,3,[9][10][11][12][13] This is the first randomized study comparing daylight exposure with blue light exposure in PDT for the treatment of AKs. No statistical difference in terms of efficacy was found between DL-PDT and c-PDT, with a mean difference of cleared AKs of 0.5 AE 6.2 (P = 0.8460) between the two sides.…”

“…Our study showed that the response was maintained at 6 months, with a reduction of more than 90% when using DL‐PDT. A systematic review was performed in 2019 and only three studies on AKs reported a 12‐month long‐term efficacy of MAL DL‐PDT, but only one study was compared to red light in AKs. In 2017, Fargnoli et al ., found that the 12‐month clearance rate was significantly higher for c‐PDT with red light than with DL‐PDT through a study on 35 patients, treating a total of 672 AKs.…”

Conventional vs. daylight photodynamic therapy for patients with actinic keratosis on face and scalp: 12‐month follow‐up results of a randomized, intra‐individual comparative analysis

“…Differences in study design, treatment protocols, as well as light sources used do not allow direct comparison of the outcomes. Until now, there is only one published trial reporting DLPDT recurrence rates in 12 months after treatment basis . According to the results of this trial, recurrence rates of 13% were observed with 11% of AK I treated with DLPDT recurring after 12 months.…”