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Invited Commentary
Practice Gaps
December 2014

Photodynamic Therapy for Actinic KeratosesAren’t We There Yet?

Author Affiliations
  • 1Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada
JAMA Dermatol. 2014;150(12):1289. doi:10.1001/jamadermatol.2014.1869

Fifteen years ago the US Food and Drug Administration approved the use of photodynamic therapy (PDT) in dermatology for the treatment of actinic keratosis (AK). Photodynamic therapy using topical agents in combination with visible light has been investigated extensively with a general consensus that in cutaneous oncology, PDT is probably best suited for treating patients with multiple or larger superficial lesions. In a meta-analysis, Patel et al1 concluded that PDT resulted in a 14% better probability of complete clearance of AK compared with cryotherapy. Additional potential benefits of PDT such as superior cosmesis and better patient acceptance have not been demonstrated clearly. Although cryotherapy and PDT require the acquisition and use of specialized materials and equipment, only the former is typically a first-line approach for most practicing dermatologists.

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