Photodynamic Therapy Safe, Effective for Actinic Keratoses

Actinic keratosis on the hand
Actinic keratosis on the hand
Over 90% of patients and clinicians would consider using photodynamic therapy again if needed.

The use of methyl aminolevulinate daylight-photodynamic therapy (MAL-DL-PDT) for the treatment of multiple face and/or scalp actinic keratoses (AKs) is associated with high levels of patient and physician satisfaction in clinical practice, according to the results of a recent prospective, multicenter, observational study conducted in 6 European countries and published in the Journal of the European Academy of Dermatology and Venereology.

All patients in the study received a single treatment of MAL-DL-PDT for facial and/or scalp AKs. Patient questionnaires at baseline and at 3 months posttreatment were used to evaluate patient-reported outcomes. Efficacy was assessed at 3 months using a 6-point global improvement scale. Adverse events were documented at every visit.

A total of 325 patients from 52 investigational centers were enrolled in the study, and 314 of these were seen at the 3-month follow-up visit. Most of the patients had multiple lesions (58.4% had >10 lesions), which were located mainly on the scalp (60.0%) and/or forehead (52.4%). Global severity of the lesions was as follows: 39.4% were grade I, 33.2% were grade II, 27.4% were a combination of grades I and II, and 10.5% were grade III.

At the conclusion of the study, most of the patients and physicians were satisfied or very satisfied with the MAL-DL-PDT treatment (80.4% and 90.3%, respectively), with the effectiveness of the treatment (78.9% and 82.6%, respectively), and with the cosmetic appearance of the treated skin (76.9% and 98.1%, respectively). The majority of patients and physicians would consider using MAL-DL-PDT again (90.0% and 98.1%, respectively) if needed.

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At 3 months, physician-assessed efficacy was at least much improved in 83.5% of patients, with 45.9% requiring no retreatment. Treatment-related adverse events were reported in 15% of patients.

The investigators concluded that the findings from this European study are consistent with those from prior trials and demonstrate high levels of patient and physician satisfaction with MAL-DL-PDT, reflecting its effectiveness, positive safety profile, and convenience.


Fargnoli MC, Ibbotson SH, Hunger RE, 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 [published online November 14, 2017]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.14691