Daylight photodynamic therapy in Scotland.

Area of Science:

• Dermatology
• Photomedicine
• Oncology

Background:

• Actinic keratoses (AKs) are common, sun-induced skin changes in fair-skinned populations, particularly in Scotland.
• Extensive AKs present a therapeutic challenge, often requiring field-directed management due to their pre-cancerous nature and potential to develop into skin cancer.
• Hospital-based photodynamic therapy (PDT) using red LED light is established in Scotland, but daylight-activated PDT had not been explored.

Purpose of the Study:

• To evaluate the efficacy, tolerability, and patient satisfaction of daylight-activated photodynamic therapy (DL-PDT) for treating extensive actinic keratoses in Scotland.
• To determine the feasibility of DL-PDT in the Scottish climate.
• To explore DL-PDT as a potential advancement in managing pre-cancerous skin field changes.

Main Methods:

• Retrospective analysis of 64 patient-treatment courses of DL-PDT for actinic keratoses.
• Assessment of treatment outcomes, including clearance rates and patient satisfaction.
• Measurement of daylight exposure to determine treatment feasibility periods.

Main Results:

• DL-PDT was found to be an effective and well-tolerated treatment for actinic keratoses.
• A significant majority of patients (73%) achieved clearance or a good response to DL-PDT.
• High levels of patient satisfaction were reported, with treatment feasible in Scotland from April to September.

Conclusions:

• Daylight photodynamic therapy is an effective, well-tolerated, and patient-preferred treatment option for extensive actinic keratoses in Scotland.
• DL-PDT offers a viable alternative to traditional PDT, with potential for home-based treatment and improved service efficiency.
• The findings support the implementation of DL-PDT as an important advancement for managing pre-cancerous skin changes in Scotland.