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Topical photodynamic therapy (PDT) is widely used as an effective and well‐tolerated treatment for field change actinic keratosis, Bowen disease and superficial basal cell carcinoma. There is a strong evidence base to support its use and guidelines, which summarise the evidence and clinical utility of this therapy. There are also standards available for guidance with respect to establishing PDT services in dermatology and emphasis is placed on the availability of PDT for practitioners affiliated with a skin cancer multi‐disciplinary team. Developments in photosensitisers and light delivery, such as through the increasing application of daylight PDT, have greatly improved the tolerance, acceptability and uptake of PDT, such that this should be widely available through dermatology services. Further refinements in photosensitiser and light delivery will be expected to continue to improve PDT outcomes and the uptake of this invaluable therapeutic approach.
Topical photodynamic therapy (PDT) is widely used as an effective and well‐tolerated treatment for field change actinic keratosis, Bowen disease and superficial basal cell carcinoma. There is a strong evidence base to support its use and guidelines, which summarise the evidence and clinical utility of this therapy. There are also standards available for guidance with respect to establishing PDT services in dermatology and emphasis is placed on the availability of PDT for practitioners affiliated with a skin cancer multi‐disciplinary team. Developments in photosensitisers and light delivery, such as through the increasing application of daylight PDT, have greatly improved the tolerance, acceptability and uptake of PDT, such that this should be widely available through dermatology services. Further refinements in photosensitiser and light delivery will be expected to continue to improve PDT outcomes and the uptake of this invaluable therapeutic approach.
Porokeratoses represent a rare group of skin diseases characterized by abnormal keratinization. The condition may have a genetic background and can be triggered by environmental factors, including UV exposure and infections. Several clinical variants of porokeratosis can be distinguished, including Mibelli’s porokeratosis, disseminated superficial actinic porokeratosis, superficial disseminated porokeratosis, and porokeratosis palmaris plantaris et disseminata. Diagnosis is established based on clinical and histopathological examination, dermatoscopy, and reflectance confocal microscopy. Various treatment options are available, including topical combination therapy with cholesterol and statins, topical retinoids, cryotherapy, laser therapy, and surgical excision of lesions, but none are fully effective. The success of these treatments can vary significantly based on the specific type of porokeratosis and individual patient characteristics, with many outcomes falling short of expectations. Since the disease is considered a precancerous condition, patients with porokeratosis should remain under regular dermatological control.
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