Daylight Photodynamic Therapy

Abstract

Photodynamic therapy (PDT) has been used extensively to treat actinic keratoses (AKs) and less so nonmelanoma skin cancers (NMSC). Conventional in-office treatment is limited by intensive time requirements and patient discomfort. A new trend toward the use of daylight as a light source either clinically monitored or self-supervised is gaining acceptance. To assess the current published data on daylight photodynamic therapy (dPDT) and identify knowledge gaps. A systematic search of the PubMed archives using the terms daylight PDT, daylight-PDT, daylight photodynamic therapy, and ambient light and photodynamic therapy was conducted on May 18, 2015. No restrictions were used for the search string. Seventeen published works were identified on the use of dPDT; 8 randomized studies, 4 prospective cohort studies, 1 case series, 1 case report, and 3 retrospective studies. Complete response rates for treatment of AKs from randomized trials range from 46% to 89.2%. Daylight PDT has been demonstrated to have high efficacy with results similar to conventional PDT for the treatment of AKs. Initial reports regarding treatment of NMSC indicate recurrence rates much higher than other accepted therapies. Pain associated with treatment seems to be significantly less than for conventional PDT.