Y Gilaberte1, M Aguilar2, M Almagro3, O Correia4, C Guillén5, A Harto6, B Pérez-García6, L Pérez-Pérez7, P Redondo8, I Sánchez-Carpintero9, C Serra-Guillén5, L M Valladares10. 1. Unidad de Dermatología, Hospital San Jorge, Huesca, España. Electronic address: ygilaberte@salud.aragon.es. 2. Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España. 3. Servicio de Dermatología, Complejo Hospitalario Universitario, La Coruña, España. 4. Centro de Dermatología Epidermis, Instituto CUF, Oporto y Facultad de Medicina, Universidad de Oporto, Oporto, Portugal. 5. Servicio de Dermatología, Instituto Valencia de Oncología, Valencia, España. 6. Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España. 7. Servicio de Dermatología, Estructura Organizativa de Gestión Integrada (EOXI) de Vigo, Clínica Pérez & Gavín dermatólogos, Vigo, España. 8. Servicio de Dermatología, Clínica Universitaria de Navarra, Pamplona, España. 9. Clínica Ruber y Clínica Dermatológica Internacional, Madrid, España. 10. Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España.
Abstract
INTRODUCTION: Daylight-mediated photodynamic therapy (PDT) is a new type of PDT that is as effective as conventional PDT in grade 1 and 2 actinic keratosis but with fewer adverse effects, resulting in greater efficiency. The climatic conditions in the Iberian Peninsula require an appropriately adapted consensus protocol. OBJECTIVE: We describe a protocol for the treatment of grade 1 and 2 actinic keratosis with daylight-mediated PDT and methyl aminolevulinate (MAL) adapted to the epidemiological and clinical characteristics of Spanish and Portuguese patients and the climatic conditions of both countries. METHODS: Twelve dermatologists from different parts of Spain and Portugal with experience in the treatment of actinic keratosis with PDT convened to draft a consensus statement for daylight-mediated PDT with MAL in these countries. Based on a literature review and their own clinical experience, the group developed a recommended protocol. RESULTS: According to the recommendations adopted, patients with multiple grade 1 and 2 lesions, particularly those at risk of developing cancer, are candidates for this type of therapy. Daylight-mediated PDT can be administered throughout the year, although it is not indicated at temperatures below 10°C or at excessively high temperatures. Likewise, therapy should not be administered when it is raining, snowing, or foggy. The procedure is simple, requiring application of a sunscreen with a protection factor of at least 30 based exclusively on organic filters, appropriate preparation of the lesions, application of MAL without occlusion, and activation in daylight for 2hours. CONCLUSION: This consensus statement represents a practical and detailed guideline to achieve maximum effectiveness of daylight-mediated PDT with MAL in Spain and Portugal with minimal adverse effects.
INTRODUCTION: Daylight-mediated photodynamic therapy (PDT) is a new type of PDT that is as effective as conventional PDT in grade 1 and 2 actinic keratosis but with fewer adverse effects, resulting in greater efficiency. The climatic conditions in the Iberian Peninsula require an appropriately adapted consensus protocol. OBJECTIVE: We describe a protocol for the treatment of grade 1 and 2 actinic keratosis with daylight-mediated PDT and methyl aminolevulinate (MAL) adapted to the epidemiological and clinical characteristics of Spanish and Portuguese patients and the climatic conditions of both countries. METHODS: Twelve dermatologists from different parts of Spain and Portugal with experience in the treatment of actinic keratosis with PDT convened to draft a consensus statement for daylight-mediated PDT with MAL in these countries. Based on a literature review and their own clinical experience, the group developed a recommended protocol. RESULTS: According to the recommendations adopted, patients with multiple grade 1 and 2 lesions, particularly those at risk of developing cancer, are candidates for this type of therapy. Daylight-mediated PDT can be administered throughout the year, although it is not indicated at temperatures below 10°C or at excessively high temperatures. Likewise, therapy should not be administered when it is raining, snowing, or foggy. The procedure is simple, requiring application of a sunscreen with a protection factor of at least 30 based exclusively on organic filters, appropriate preparation of the lesions, application of MAL without occlusion, and activation in daylight for 2hours. CONCLUSION: This consensus statement represents a practical and detailed guideline to achieve maximum effectiveness of daylight-mediated PDT with MAL in Spain and Portugal with minimal adverse effects.
Authors: Kayla Marra; Ethan P LaRochelle; M Shane Chapman; P Jack Hoopes; Karina Lukovits; Edward V Maytin; Tayyaba Hasan; Brian W Pogue Journal: Photochem Photobiol Date: 2018-05-16 Impact factor: 3.421