title: Treatment of face and scalp solar (actinic) keratosis with daylight-mediated photodynamic therapy is possible throughout the year in Australia: Evidence from a clinical and meteorological study.
abstract: OBJECTIVE
  Solar (actinic) keratosis (AK) is an emergent concern worldwide and is associated with an increased risk of development of non-melanoma skin cancer, especially squamous cell carcinoma. Daylight-mediated photodynamic therapy (DL-PDT) using methyl aminolaevulinate cream has proved to be an effective, nearly painless, and more convenient alternative to conventional PDT for the treatment of AK. In a phase III, randomised, controlled trial performed in Australia, the mean irradiance (light intensity) received by patients during DL-PDT treatment, assessed via a spectroradiometer, was 305 W/m(2) (min. 40 to max. 585 W/m(2) ) with similar efficacy irrespective of intensity or dose. The objective of the present meteorological study was to assess the suitability of natural daylight to perform DL-PDT for the treatment of face and scalp AK during different periods of the year and different geographical locations and latitudes across Australia.
  
  
  METHODS
  To determine daylight irradiance during a complete year in eight different geographical locations throughout Australia, we used meteorological software (Meteonorm, Meteotest, Bern, Switzerland), and available solar radiation and weather data from 1986-2005.
  
  
  RESULTS
  The average daily irradiance remained within the levels (40-585 W/m(2) ) measured during the clinical DL-PDT study in Australia, throughout the year and in all geographical locations investigated (yearly average from Darwin 548 W/m(2) to Hobart 366 W/m(2) ).
  
  
  CONCLUSIONS
  DL-PDT for the treatment of face and scalp AK in Australia can be performed effectively throughout the entire year as long as weather conditions permit daylight exposure and allow participants to remain under direct light for 2 h.
authors.affiliation: Specialist Connect, Woolloongabba, Queensland, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Lynda
authors.initials: L
authors.lastname: Spelman
authors.affiliation: Woden Dermatology, Canberra, ACT, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Diana
authors.initials: D
authors.lastname: Rubel
authors.affiliation: Sydney and University of NSW, Sydney, New South Wales, Australia.
authors.forename: Dedee F
authors.initials: DF
authors.lastname: Murrell
authors.affiliation: Central Sydney Dermatology, Sydney, New South Wales, Australia.
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: See
authors.affiliation: Skin and Cancer Foundation, Sydney, New South Wales, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hewitt
authors.affiliation: Skin and Cancer Foundation Inc., Victoria, Australia.|University of Melbourne, Victoria, Australia.|St Vincent's Hospital, Melbourne, Victoria, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Foley
authors.affiliation: Illawarra Dermatology and Laser Clinic, Wollongong, New South Wales, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Salmon
authors.affiliation: Galderma International, Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Kerob
authors.affiliation: Galderma R&D SNC, Sophia Antipolis, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pascual
authors.affiliation: St George Dermatology and Skin Cancer Centre, Sydney, New South Wales, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Shumack
authors.affiliation: Westmead Clinical School, Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Pablo
authors.identifier: http://orcid.org/0000-0003-4882-1564
authors.initials: P
authors.lastname: Fernandez-Penas
mesh_terms: D000622:Aminolevulinic Acid / Q000627:therapeutic use; D001315:Australia; D005148:Facial Dermatoses / Q000188:drug therapy*; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy*; D055904:Meteorology / Q000706:statistics & numerical data; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012536:Scalp Dermatoses / Q000188:drug therapy*; D013472:Sunlight; D013997:Time Factors
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid
keywords: Australia; daylight irradiance; daylight-mediated photodynamic therapy; meteorological study; methyl aminolaevulinate; solar (actinic) keratosis
references.citation: Br J Dermatol. 2000 Jun;142(6):1154-9
references.pmid: 10848739
references.citation: Br J Dermatol. 2007 Feb;156(2):222-30
references.pmid: 17223860
references.citation: Br J Dermatol. 2008 Apr;158(4):740-6
references.pmid: 18294318
references.citation: Br J Dermatol. 2009 Jun;160(6):1308-14
references.pmid: 19416257
references.citation: Br J Dermatol. 2011 May;164(5):1083-90
references.pmid: 21219287
references.citation: Photodermatol Photoimmunol Photomed. 2011 Dec;27(6):280-5
references.pmid: 22092730
references.citation: J Eur Acad Dermatol Venereol. 2012 Jun;26(6):673-9
references.pmid: 22211665
references.citation: Br J Dermatol. 2012 Jun;166(6):1327-32
references.pmid: 22250644
references.citation: Br J Dermatol. 2013 Jan;168(1):186-91
references.pmid: 22860885
references.citation: Acta Derm Venereol. 2012 Nov;92(6):652-3
references.pmid: 22930201
references.citation: J Eur Acad Dermatol Venereol. 2013 May;27(5):536-44
references.pmid: 23181594
references.citation: Br J Dermatol. 2014 Nov;171(5):1164-71
references.pmid: 24861492
references.citation: Br J Dermatol. 1994 Oct;131(4):455-64
references.pmid: 7947197