Skip to main content
SpringerLink
Log in

Daylight Photodynamic Therapy for Actinic Keratoses

  • Review Article
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Topical photodynamic therapy (PDT) using daylight is effective in the treatment of actinic keratoses (AKs), offering the potential for treatment of large fields such as full face and balding scalp, but with minimal therapy-associated pain. Comparison with conventional PDT indicates similar efficacy for thin and moderate-thickness AKs, but with significantly less discomfort/pain, driving a patient preference for daylight-mediated PDT (DL-PDT) compared with conventional PDT using high-intensity office/hospital-based light sources. Treatment protocol involves the application of a photosensitizing agent without occlusion and subsequent exposure to ambient daylight within 30 min, with patients exposed to daylight for 1.5–2.0 h. Pivotal randomized controlled trials in Europe and Australia have confirmed the efficacy of methyl aminolevulinic acid (MAL) DL-PDT in comparison with conventional MAL-PDT for mild and moderate-thickness lesions on the face and scalp. Initial clearance rates of 70–89% are reported. DL-PDT using a nanoemulsion aminolevulinic acid (ALA) has recently been shown to be at least as effective as MAL DL-PDT in treating mild and moderate-thickness AKs. DL-PDT may offer a better-tolerated method for treating patients with extensive AK disease. There is emerging literature on the potential for field PDT to reduce the number of new AKs developing, potentially preventing/slowing skin cancer development. Conventional PDT remains established as a therapy for Bowen’s disease (squamous cell carcinoma in situ), superficial and certain thin basal cell carcinomas (BCCs), and AKs. The evidence for the use of DL-PDT beyond AK is limited, although has been reported in actinic cheilitis, superficial BCC, and acne and cutaneous leishmaniasis. There is emerging interest in combination therapy for AK, using one or more field therapies such as DL-PDT as an option to complement with localized treatment for residual lesions. We review current recommendations and consider the appropriate place for DL-PDT in our treatment armamentarium.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Braathen LR, Szeimies RM, Basset-Seguin N, Bissonnette R, Foley P, Pariser D, et al. Guidelines on the use of photodynamic therapy for nonmelanoma skin cancer: An international consensus. J Am Acad Dermatol. 2007;56:125–43.

    Article  PubMed  Google Scholar 

  2. Morton CA, McKenna KE, Rhodes LE. Guidelines for topical photodynamic therapy. Br J Dermatol. 2008;159:1245–66.

    Article  PubMed  CAS  Google Scholar 

  3. Morton CA, Szeimies RM, Sidoroff A, Braathen LR. European guidelines for topical photodynamic therapy part 1: treatment delivery and current indications—actinic keratoses, Bowen’s disease, basal cell carcinoma. J Eur Acad Dermatol Venereol. 2013;27:536–44.

    Article  PubMed  CAS  Google Scholar 

  4. Morton C, Szeimies RM, Sidoroff A, Wennberg AM, Basset-Seguin N, Calzavara-Pinton P, et al. European Dermatology Forum European Dermatology Forum Guidelines on topical photodynamic therapy. Eur J Dermatol. 2015;25:296–311.

    PubMed  Google Scholar 

  5. Touma D, Yaar M, Whitehead S, Konnikov N, Gilchrest BA. A trial of short incubation, broad-area photodynamic therapy for facial actinic keratoses and diffuse photodamage. Arch Dermatol. 2004;140(1):33–40.

    Article  PubMed  CAS  Google Scholar 

  6. Kim M, Jung HY, Park HJ. Topical PDT in the treatment of benign skin diseases: principles and new applications. Int J Mol Sci. 2015;16:23259–78.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Fritsch C, Lang K, Schulte KW, Neuse W, Ruzicka T, Lehman P. Fluorescence diagnosis and photodynamic therapy in dermatology: an overview. In: Patrice T, editor. photodynamic therapy. Cambridge: Royal Society of Chemistry; 2003. p. 177–212.

    Chapter  Google Scholar 

  8. Grapengiesser S, Ericson M, Gudmundsson F, Larkö O, Rosén A, Wennberg AM. Pain caused by photodynamic therapy of skin cancer. Clin Exp Dermatol. 2002;27:493–7.

    Article  PubMed  CAS  Google Scholar 

  9. Wiegell SR, Wulf HC, Szeimies RM, Basset-Seguin N, Bissonnette R, Gerritsen MJ, et al. Daylight photodynamic therapy for actinic keratosis: an international consensus: International Society for Photodynamic Therapy in Dermatology. J Eur Acad Dermatol Venereol. 2012;26:673–9.

    Article  PubMed  CAS  Google Scholar 

  10. Osman-Ponchet H, Sevin K, Gaborit A. Lack of effect of selected sunscreens applied on ex vivo human skin for 5-methyl-aminolevulinic acid penetration and protoporphyrin IX photoactivation. Photodiagnosis Photodyn Ther. 2017;17:75–81.

    Article  PubMed  CAS  Google Scholar 

  11. Gholam P, Fink C, Bosselmann I, Enk AH. Retrospective analysis evaluating the effect of a keratolytic and physical pretreatment with salicylic acid, urea and curettage on the efficacy and safety of photodynamic therapy of actinic keratoses with methylaminolaevulinate. J Eur Acad Dermatol Venereol. 2016;30:619–23.

    Article  PubMed  CAS  Google Scholar 

  12. Wiegell SR, Petersen B, Wulf HC. Topical corticosteroid reduces inflammation without compromising the efficacy of photodynamic therapy for actinic keratoses: a randomized clinical trial. Br J Dermatol. 2014;171:1487–92.

    Article  PubMed  CAS  Google Scholar 

  13. Wiegell SR, Fabricius S, Stender IM, Berne B, Kroon S, Andersen BL, et al. A randomized, multicentre study of directed daylight exposure times of 1(1/2) vs. 2(1/2) h in daylight-mediated photodynamic therapy with methyl aminolaevulinate in patients with multiple thin actinic keratoses of the face and scalp. Br J Dermatol. 2011;164:1083–90.

    Article  PubMed  CAS  Google Scholar 

  14. Wiegell SR, Fabricius S, Heydenreich J, Enk CD, Rosso S, Bäumler W, et al. Weather conditions and daylight-mediated photodynamic therapy: protoporphyrin IX-weighted daylight doses measured in six geographical locations. Br J Dermatol. 2013;168:186–91.

    Article  PubMed  CAS  Google Scholar 

  15. 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:e488–93.

    Article  PubMed  CAS  Google Scholar 

  16. Spelman L, Rubel D, Murrell DF, et al. Treatment of face and scalp solar (actinic) keratosis with daylight-mediated photodynamic therapy is possible throughout the year in Australia: Evidence from a clinical and meteorological study. Australas J Dermatol. 2016;57:24–8.

    Article  PubMed  Google Scholar 

  17. Dirschka T, Radny P, Dominicus R, Mensing H, Brüning H, Jenne L, et al. Photodynamic therapy with BF-200 ALA for the treatment of actinic keratosis: results of a multicentre, randomized, observer-blind phase III study in comparison with a registered methyl-5-aminolaevulinate cream and placebo. Br J Dermatol. 2012;166:137–46.

    Article  PubMed  CAS  Google Scholar 

  18. Wiegell SR, Haedersdal M, Philipsen PA, Eriksen P, Enk CD, Wulf HC. 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;158:740–6.

    Article  PubMed  CAS  Google Scholar 

  19. Wiegell SR, Haedersdal M, Eriksen P, Wulf HC. Photodynamic therapy of actinic keratoses with 8% and 16% methyl aminolaevulinate and home-based daylight exposure: a double-blinded randomized clinical trial. Br J Dermatol. 2009;160:1308–14.

    Article  PubMed  CAS  Google Scholar 

  20. Wiegell SR, Fabricius S, Gniadecka M, Stender IM, Berne B, Kroon S, et al. Daylight-mediated photodynamic therapy of moderate to thick actinic keratoses of the face and scalp: a randomized multicentre study. Br J Dermatol. 2012;166:1327–32.

    Article  PubMed  CAS  Google Scholar 

  21. Rubel DM, Spelman L, Murrell DF, See JA, Hewitt D, Foley P, et al. Daylight PDT with methyl aminolevulinate cream as a convenient, similarly effective, nearly painless alternative to conventional PDT in actinic keratosis treatment: a randomised controlled trial. Br J Dermatol. 2014;171:1164–71.

    Article  PubMed  CAS  Google Scholar 

  22. Lacour JP, Ulrich C, Gilaberte Y, Von Felbert V, Basset-Seguin N, Dreno B, et al. Daylight photodynamic therapy with methyl aminolevulinate cream is effective and nearly painless in treating actinic keratoses: a randomised, investigator-blinded, controlled, phase III study throughout Europe. J Eur Acad Dermatol Venereol. 2015;29:2342–8.

    Article  PubMed  CAS  Google Scholar 

  23. Fargnoli MC, Ibbotson SH, Hunger RE, Rostain G, Gaastra MTW, Eibenschutz L, et al. Patient and physician satisfaction in an observational study with methyl aminolevulinate daylight-photodynamic therapy in the treatment of multiple actinic keratoses of the face and scalp in 6 European countries. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.14691 (Epub 14 Nov 2017).

  24. Fargnoli MC, Piccioni A, Neri L, et al. Conventional vs. daylight methyl aminolevulinate photodynamic therapy for actinic keratosis of the face and scalp: an intra-patient, prospective, comparison study in Italy. J Eur Acad Dermatol Venereol. 2015;29:1926–32.

    Article  PubMed  CAS  Google Scholar 

  25. Braathen LR. Daylight photodynamic therapy in private practice in Switzerland: gain without pain. Acta Derm Venereol. 2012;92:652–3.

    Article  PubMed  Google Scholar 

  26. Grinblat BM, Festa Neto C, Sanches JA Jr, Szeimies RM, Oliveira AP, Torezan LA. Daylight photodynamic therapy for actinic keratoses in São Paulo. Brazil. Photodermatol Photoimmunol Photomed. 2015;31:54–6.

    Article  PubMed  Google Scholar 

  27. Galvão LEG, Gonçalves HS, Botelho KP, Caldas JC. Daylight photodynamic therapy - Experience and safety in treatment of actinic keratoses of the face and scalp in low latitude and high brightness region. Anais Brasileiros de Dermatologia. 2017;92:142–4.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Neittaanmäki-Perttu N, Karppinen TT, Grönroos M, Tani TT, Snellman E. Daylight photodynamic therapy for actinic keratoses: a randomized double-blinded nonsponsored prospective study comparing 5-aminolaevulinic acid nanoemulsion (BF-200) with methyl-5-aminolaevulinate. Br J Dermatol. 2014;171:1172–80.

    Article  PubMed  CAS  Google Scholar 

  29. EU Clinical Trials Register. EudraCT number 2015-004382-83. https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-004382-83/results. Accessed 22 Apr 2018.

  30. Fargnoli MC, Piccioni A, Neri L, Tambone S, Pellegrini C, Peris K. Long-term efficacy and safety of daylight photodynamic therapy with methyl amninolevulinate for actinic keratosis of the face and scalp. Eur J Dermatol. 2017;27:89–91.

    PubMed  Google Scholar 

  31. Dragieva G, Hafner J, Dummer R, Schmid-Grendelmeier P, Roos M, Prinz BM, et al. Topical photodynamic therapy in the treatment of actinic keratoses and Bowen’s disease in transplant recipients. Transplantation. 2004;77:115–21.

    Article  PubMed  Google Scholar 

  32. Perrett CM, McGregor JM, Warwick J, Karran P, Leigh IM, Proby CM, et al. Treatment of posttransplant premalignant skin disease: a randomized intrapatient comparative study of 5-fluorouracil cream and topical photodynamic therapy. Br J Dermatol. 2007;156:320–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  33. Togsverd-Bo K, Lei U, Erlendsson AM, Taudorf EH, Philipsen PA, Wulf HC, et al. Combination of ablative fractional laser and daylight-mediated photodynamic therapy for actinic keratosis in organ transplant recipients: a randomized controlled trial. Br J Dermatol. 2015;172:467–74.

    Article  PubMed  CAS  Google Scholar 

  34. Gupta AK, Paquet M, Villanueva E, Brintnell W. Interventions for actinic keratoses. Cochrane Database Syst Rev 2012;(12):CD004415.

  35. Patel G, Armstrong AW, Eisen DB. Efficacy of photodynamic therapy vs other interventions in randomized clinical trials for the treatment of actinic keratoses: a systematic review and meta - analysis. JAMA Dermatol. 2014;150:1281–8.

    Article  PubMed  Google Scholar 

  36. de Berker D, McGregor JM, Mohd Mustapa MF, Exton LS, Hughes BR. British Association of Dermatologists’ guidelines for the care of patients with actinic keratosis 2017. Br J Dermatol. 2017;176:20–43.

    Article  PubMed  Google Scholar 

  37. Genovese G, Fai D, Fai C, Mavilia L, Mercuri SR. Daylight methyl-aminolevulinate photodynamic therapy versus ingenol mebutate for the treatment of actinic keratoses: an intraindividual comparative analysis. Dermatol Ther. 2016;29:191–6.

    Article  PubMed  Google Scholar 

  38. Lucena SR, Salazar N, Gracia-Cazaña T, Zamarrón A, González S, Juarranz A, et al. Combined treatments with photodynamic therapy for non-melanoma skin cancer. Int J Mol Sci. 2015;16:25912–33.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Nissen CV, Heerfordt IM, Wiegell SR, Mikkelsen CS, Wulf HC. Pretreatment with 5-fluorouracil cream enhances the efficacy of daylight-mediated photodynamic therapy for actinic keratosis. Acta Derm Venereol. 2017;97:617–21.

    Article  PubMed  CAS  Google Scholar 

  40. Czarnecki D, Meehan CJ, Bruce F, Culjak G. The majority of cutaneous squamous cell carcinomas arise in actinic keratoses. J Cutan Med Surg. 2002;6:207–9.

    Article  PubMed  CAS  Google Scholar 

  41. Apalla Z, Sotiriou E, Chovarda E, Lefaki I, Devliotou-Panagiotidou D, Ioannides D. Skin cancer: preventive photodynamic therapy in patients with face and scalp cancerization. A randomized placebo-controlled study. Br J Dermatol. 2010;162:171–5.

    Article  PubMed  CAS  Google Scholar 

  42. Reinhold U, Dirschka T, Ostendorf R, Aschoff R, Berking C, Philipp-Dormston WG, et al. A randomized, double-blind, phase III, multicentre study to evaluate the safety and efficacy of BF-200 ALA (Ameluz®) vs. placebo in the field-directed treatment of mild-to-moderate actinic keratosis with photodynamic therapy when using the BF-RhodoLED® lamp. Br J Dermatol. 2016;175:696–705.

    Article  PubMed  CAS  Google Scholar 

  43. Sotiriou E, Apalla Z, Vrani F, et al. Daylight photodynamic therapy vs Conventional photodynamic therapy as skin cancer preventive treatment in patients with face and scalp cancerization: an intra-individual comparison study. J Eur Acad Dermatol Venereol. 2017;31:1303–7.

    Article  PubMed  CAS  Google Scholar 

  44. Wulf HC, Pavel S, Stender I, Bakker-Wensveen CA. Topical photodynamic therapy for prevention of new skin lesions in renal transplant recipients. Acta Derm Venereol. 2006;86:25–8.

    PubMed  CAS  Google Scholar 

  45. Wennberg AM, Stenquist B, Stockfleth E, et al. Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study. Transplantation. 2008;86:423–9.

    Article  PubMed  CAS  Google Scholar 

  46. Seubring I, Groenewoud JMM, Gerritsen MP. Comparison of “Lesion-by-Lesion” and field photodynamic therapy in the prevention of actinic keratoses: a randomized, split-face, Single-Blind Pilot Study. Dermatology. 2016;232:708–14.

    Article  PubMed  CAS  Google Scholar 

  47. Braathen LR, Morton CA, Basset-Seguin N, Bissonnette R, Gerritsen MJP, Gilaberte Y, et al. Photodynamic therapy for skin field cancerization: an international consensus. International Society for Photodynamic Therapy in Dermatology. J Eur Acad Dermatol Venereol. 2012;26:1063–6.

    Article  PubMed  CAS  Google Scholar 

  48. Ruiz-Rodriguez R, Sanz-Sanchez T, Cordoba S, et al. Photodynamic photorejuvenation. Dermatol Surg. 2002;28:742–4.

    PubMed  CAS  Google Scholar 

  49. Issa MC, Pineiro-Maceira J, Vieira MT, Olej B, Mandarim-de-Lacerda CA, Luiz RR, et al. Photorejuvenation with topical methyl aminolevulinate and red light: a randomized, prospective, clinical, histopathologic, and morphometric study. Dermatol Surg. 2010;36:39–48.

    Article  PubMed  Google Scholar 

  50. Piccioni A, Fargnoli MC, Schoinas S, Suppa M, Frascione P, Ginebri A, et al. Efficacy and tolerability of 5-aminolevulinic acid 0.5% liposomal spray and intense pulsed light in wrinkle reduction of photodamaged skin. J Dermatol Treat. 2011;22:247–53.

    Article  CAS  Google Scholar 

  51. Sanclemente G, Medina L, Villa JF, Barrera LM, Garcia HI. A prospective split-face double-blind randomized placebo-controlled trial to assess the efficacy of methyl aminolevulinate + red-light in patients with facial photodamage. J Eur Acad Dermatol Venereol. 2011;25:49–58.

    Article  PubMed  CAS  Google Scholar 

  52. Park MY, Sohn S, Lee ES, Kim YC. Photorejuvenation induced by 5-aminolevulinic acid photodynamic therapy in patients with actinic keratosis: a histologic analysis. J Am Acad Dermatol. 2010;62:85–95.

    Article  PubMed  CAS  Google Scholar 

  53. Szeimies RM, Torezan L, Niwa A, Valente N, Unger P, Kohl E, et al. Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy. Br J Dermatol. 2012;167:150–9.

    Article  PubMed  CAS  Google Scholar 

  54. Bagazgoitia L, Cuevas Santos J, Juarranz A, Jaen P. Photodynamic therapy reduces the histological features of actinic damage and the expression of early oncogenic markers. Br J Dermatol. 2011;165:144–51.

    Article  PubMed  CAS  Google Scholar 

  55. Philipp-Dormston WG, Sanclemente G, Torezan L, et al. Daylight photodynamic therapy with MAL cream for large-scale photodamaged skin based on the concept of ‘actinic field damage’: recommendations of an international expert group. J Eur Acad Dermatol Venereol. 2016;30:8–15.

    Article  PubMed  CAS  Google Scholar 

  56. Sanclemente G, Mancilla GA, Hernandez G. A double-blind randomized controlled trial to assess the efficacy of daylight photodynamic therapy with methyl-aminolevulinate vs. Placebo and daylight in patients with facial photodamage. Actas Dermo-Sifiliográficas. 2016;107:224–34.

    PubMed  CAS  Google Scholar 

  57. Kohl E, Koller M, Zeman F, et al. Daylight photodynamic therapy versus cryosurgery for the treatment and prophylaxis of actinic keratoses of the face—protocol of a multicenter, prospective, randomized, controlled, two-armed study. BMC Dermatol. 2017;17:12.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Lane KL, Hovenic W, Ball K, Zachary CB. Daylight photodynamic therapy: the Southern California experience. Lasers Surg Med. 2015;47:168–72.

    Article  PubMed  Google Scholar 

  59. Kasche A, Luderschmidt S, Ring J, Hein R. Photodynamic therapy induces less pain in patients treated with methyl aminolevulinate compared to aminolevulinic acid. J Drugs Dermatol. 2006;5:353–6.

    PubMed  CAS  Google Scholar 

  60. Neittaanmäki-Perttu N, Grönroos M, Karppinen T, Snellman E, Rissanen P. Photodynamic Therapy for Actinic Keratoses: A Randomized Prospective Non-sponsored Cost-effectiveness Study of Daylight-mediated Treatment Compared with Light-emitting Diode Treatment. Acta Derm Venereol. 2016;96:241–4.

    Article  PubMed  Google Scholar 

  61. Lerche CM, Heerfordt IM, Heydenreich J, Wulf HC. Alternatives to outdoor daylight illumination for photodynamic therapy: use of greenhouses and artificial light sources. Int J Mol Sci. 2016;17:309.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Kellner C, Bauriedl S, Hollstein S, Reinhold U. Simulated-daylight photodynamic therapy with BF-200 aminolaevulinic acid for actinic keratosis: assessment of the efficacy and tolerability in a retrospective study. Br J Dermatol. 2015;172:1146–8.

    Article  PubMed  CAS  Google Scholar 

  63. O’Gorman SM, Clowry J, Manley M, McCavana J, Gray L, Kavanagh A, et al. Artificial white light vs daylight photodynamic therapy for actinic keratoses: a randomized clinical trial. JAMA Dermatol. 2016;152:638–44.

    Article  PubMed  Google Scholar 

  64. Fai D, Romanello E, Brumana MB, et al. Daylight photodynamic therapy with methyl-aminolevulinate for the treatment of actinic cheilitis. Dermatol Ther. 2015;28:355–68.

    Article  PubMed  Google Scholar 

  65. Wiegell SR, Skødt V, Wulf HC. Daylight-mediated photodynamic therapy of basal cell carcinomas—an explorative study. J Eur Acad Dermatol Venereol. 2014;28:169–75.

    Article  PubMed  CAS  Google Scholar 

  66. Kwon HH, Moon KR, Park SY, Yoon JY, Suh DH, Lee JB. Daylight photodynamic therapy with 1.5% 3-butenyl 5-aminolevulinate gel as a convenient, effective and safe therapy in acne treatment: A double-blind randomized controlled trial. J Dermatol. 2016;43:515–21.

    Article  PubMed  CAS  Google Scholar 

  67. Enk CD, Nasereddin A, Alper R, Dan-Goor M, Jaffe CL, Wulf HC. Cutaneous leishmaniasis responds to daylight-activated photodynamic therapy: proof of concept for a novel self-administered therapeutic modality. Br J Dermatol. 2015;172:1364–70.

    Article  PubMed  CAS  Google Scholar 

  68. See JA, Shumack S, Murrell DF, Rubel DM, Fernández-Peñas P, Salmon R, et al. Consensus recommendations on the use of daylight photodynamic therapy with methyl aminolevulinate cream for actinic keratoses in Australia. Australas J Dermatol. 2016;57:167–74.

    Article  PubMed  Google Scholar 

  69. Grinblat B, Galimberti G, Chouela E, Sanclemente G, Lopez M, Alcala D, et al. Daylight-mediated photodynamic therapy for actinic damage in Latin America: consensus recommendations. Photodermatol Photoimmunol Photomed. 2016;32:81–7.

    Article  PubMed  Google Scholar 

  70. Morton CA, Wulf HC, Szeimies RM, Gilaberte Y, Basset-Seguin N, Sotiriou E, et al. Practical approach to the use of daylight photodynamic therapy with topical methylaminolevulinate for actinic keratosis: a European consensus. J Eur Acad Dermatol Venereol. 2015;29:1718–23.

    Article  PubMed  CAS  Google Scholar 

  71. Ibbotson S, Stones R, Bowling J, Campbell S, Kownacki S, Sivaramakrishnan M, et al. A consensus on the use of daylight photodynamic therapy in the UK. J Dermatolog Treat. 2017;28:360–7.

    Article  PubMed  CAS  Google Scholar 

  72. Gilaberte Y, Aguilar M, Almagro M, Correia O, Guillén C, Harto A, et al. Spanish-Portuguese consensus statement on use of daylight-mediated photodynamic therapy with methyl aminolevulinate in the treatment of actinic keratosis. Actas Dermosifiliogr. 2015;106:623–31.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Stirling Community Hospital, Stirling, FK8 2AU, UK

    Colin A. Morton

  2. Dermatology, Bern, Switzerland

    Lasse R. Braathen

Authors
  1. Colin A. Morton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lasse R. Braathen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Colin A. Morton.

Ethics declarations

Funding

No external funding was used in the preparation of this manuscript

Conflicts of interest

Colin A. Morton has been a member of advisory boards for Almirall, Biofrontera, Galderma, and Leo Pharma, and has received speaker honoraria from Biofrontera and Galderma. Lasse R. Braathen has received congress/travel support, and fees for lectures and advisory board participation from Galderma.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morton, C.A., Braathen, L.R. Daylight Photodynamic Therapy for Actinic Keratoses. Am J Clin Dermatol 19, 647–656 (2018). https://doi.org/10.1007/s40257-018-0360-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40257-018-0360-y

Search

Navigation