A consensus on the use of daylight photodynamic therapy in the UK

TY - JOUR

T1 - A consensus on the use of daylight photodynamic therapy in the UK

AU - Ibbotson, Sally

AU - Stones, Robin

AU - Bowling, Jonathan

AU - Campbell, Sandra

AU - Kownack, Stephen

AU - Sivaramakrishnan, Muthu

AU - Valentine, Ronan

AU - Morton, Colin A.

N1 - This paper originates from a report of an advisory board on “UK Metvix daylight activated photodynamic therapy” held in Birmingham, UK, 12 November 2014. This meeting was organised and funded by Galderma UK, who selected the participants.

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Actinic keratosis

KW - Daylight

KW - Methyl aminolevulinate

KW - Photodynamic therapy

U2 - 10.1080/09546634.2016.1240863

DO - 10.1080/09546634.2016.1240863

M3 - Article

C2 - 27788605

SN - 0954-6634

VL - 28

SP - 360

EP - 367

JO - Journal of Dermatological Treatment

JF - Journal of Dermatological Treatment

IS - 4

ER -