Daylight photodynamic therapy: experience in the treatment of actinic keratosis in San Gallicano Institute of Rome and a review of literature

BACKGROUND: Actinic keratosis (AK) is a photo-induced skin lesion. It has been considered by several authors as in situ squamous cell carcinoma (SCC), that can evolve to invasive SCC (iSCC). Given the malignant potential and because it's impossible predict which AK will evolve in iSCC, it's necessary to treat each lesion. Multiple therapeutic approaches have been described to treat AKs. In addition to the topical drugs, photodynamic therapy (PDT) has become an established therapeutic modality for grade I and II of AKs of face and scalp. Recently the daylight photo-dynamic therapy (DL-PDT) has found extensive use in the care of the AK and in the field cancerization. METHODS: 101 patients, 90 males and 11 females, mean age 71, phototype I-II, with multiple AK I and II of the face and the scalp, treated with DL-PDT were retrospectively studied. Patients were clinically evaluated for 3 months. RESULTS: The efficacy was complete in 16 patients (15,8%), in 71 patients (70,3%) was much improved or improved and only in 14 (13,9%) subjects were minimal, while nobody had worsened or changed. The majority of patients (84,2%) patients were satisfied of the efficacy as well of the cosmetic results, only 15 (14,9%) were low satisfied and one patients was no satisfied. CONCLUSIONS: This study confirms that the DL-PDT is a good alternative to c-PDT for the treatment of grade I and II AK of the face and scalp and in Rome, as in Southern Europe, it's possible to perform the DL-PDT in almost every month of year.