Scientific publications

Spanish-Portuguese Consensus Statement on Use of Daylight-Mediated Photodynamic Therapy With Methyl Aminolevulinate in the Treatment of Actinic Keratosis

Jun 23, 2015 | Magazine: Actas Dermo-sifiliográficas

Gilaberte Y(1), Aguilar M(2), Almagro M(3), Correia O(4), Guillén C(5), Harto A(6), Pérez-García B(6), Pérez-Pérez L(7), Redondo P(8), Sánchez-Carpintero I(9), Serra-Guillén C(5), Valladares LM(10).

(1) Unidad de Dermatología, Hospital San Jorge, Huesca, España.
(2) Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España.
(3) Servicio de Dermatología, Complejo Hospitalario Universitario, La Coruña, España.
(4) Centro de Dermatología Epidermis, Instituto CUF, Oporto y Facultad de Medicina, Universidad de Oporto, Oporto, Portugal.
(5) Servicio de Dermatología, Instituto Valencia de Oncología, Valencia, España.
(6) Servicio de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, España.
(7) Servicio de Dermatología, Estructura Organizativa de Gestión Integrada (EOXI) de Vigo, Clínica Pérez & Gavín dermatólogos, Vigo, España.
(8) Servicio de Dermatología, Clínica Universitaria de Navarra, Pamplona, España.
(9) Clínica Ruber y Clínica Dermatológica Internacional, Madrid, España.
(10) Servicio de Dermatología, Complejo Asistencial Universitario de León, León, España.

Daylight-mediated photodynamic therapy (PDT) is a new type of PDT that is as effective as conventional PDT in grade 1 and 2 actinic keratosis but with fewer adverse effects, resulting in greater efficiency. The climatic conditions in the Iberian Peninsula require an appropriately adapted consensus protocol.

We describe a protocol for the treatment of grade 1 and 2 actinic keratosis with daylight-mediated PDT and methyl aminolevulinate (MAL) adapted to the epidemiological and clinical characteristics of Spanish and Portuguese patients and the climatic conditions of both countries.

Twelve dermatologists from different parts of Spain and Portugal with experience in the treatment of actinic keratosis with PDT convened to draft a consensus statement for daylight-mediated PDT with MAL in these countries. Based on a literature review and their own clinical experience, the group developed a recommended protocol.

According to the recommendations adopted, patients with multiple grade 1 and 2 lesions, particularly those at risk of developing cancer, are candidates for this type of therapy. Daylight-mediated PDT can be administered throughout the year, although it is not indicated at temperatures below 10°C or at excessively high temperatures. Likewise, therapy should not be administered when it is raining, snowing, or foggy. The procedure is simple, requiring application of a sunscreen with a protection factor of at least 30 based exclusively on organic filters, appropriate preparation of the lesions, application of MAL without occlusion, and activation in daylight for 2hours.

This consensus statement represents a practical and detailed guideline to achieve maximum effectiveness of daylight-mediated PDT with MAL in Spain and Portugal with minimal adverse effects.

CITATION  Actas Dermosifiliogr. 2015 Jun 23. pii: S0001-7310(15)00276-8. doi: 10.1016/

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