A randomised, single blinded, prospective study to compare simulated daylight photodynamic therapy with natural daylight photodynamic therapy for treatment of actinic keratoses.
British Skin Foundation
St. Vincent's University Hospital
Actinic keratoses (AKs) are dysplastic epidermal lesions considered to be potential precursors of squamous cell carcinoma (SCC). Various studies have 2011 and 2015 inclusive there were 70 deaths per year attributed to keratinocyte cancers. Thus treatment of AKs prior to conversion to SCC is important. Photodynamic therapy (PDT) is a widely approved therapy for AKs. A protocol using daylight to treat AKs is widely practised. Daylight PDT (d-PDT) is very dependent on geographical location (latitude), weather conditions and time of year. It has to date been studied mostly in Nordic countries. In Denmark, a country at similar latitude to Ireland (55 degrees versus 53 degrees north) it is only possible to perform d-PDT from April to October due to low temperatures. Conventional PDT (c-PDT) is an alternative to d-PDT outside of these months but the main drawback for patients is pain. As a result, patients prefer d-PDT and in fact in Copenhagen, where they routinely offer d-PDT from April to October they have found that patients will frequently opt to defer their treatment until a time of year when d-PDT is an option. Artificial white light (AWL) has been investigated as an alternative PDT treatment to overcome this. We propose that a treatment room with 4000K white light LED flood lamps which would be orientated to provide uniform power distribution across treatment areas would mimic d-PDT and enable us to effectively treat AKs year round.
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