[Photodynamic therapy vs imiquimod]

Photodynamic therapy and imiquimod are highly regarded treatments dermatologists frequently prescribe for actinic keratoses, basal cell carcinoma, and Bowen disease. The scarcity of evidence from comparative trials prevents us from drawing well-founded conclusions about the efficacy, tolerance, and adverse effects of these therapeutic options or to recommend one over the other in any particular type of lesion or patient. On the other hand, in certain conditions (eg, actinic chelitis, immunosuppression, and basal cell carcinoma affecting the eyelids), there is evidence to support the use of photodynamic therapy or imiquimod even though they might initially seem contraindicated. We critically review and compare the use of these 2 treatments in order to suggest which is more appropriate in specific cases.