title: Consensus recommendations on the use of daylight photodynamic therapy with methyl aminolevulinate cream for actinic keratoses in Australia.
abstract: Australia has the highest prevalence of actinic keratoses (AK) worldwide. Because of the risk of transformation of AK to invasive squamous cell carcinomas, consensus guidelines recommend that AK are removed using appropriate therapies to prevent progression to invasive disease. Daylight photodynamic therapy (PDT) is emerging as an efficacious treatment for AK, particularly for patients who require treatment of large areas of chronic actinic damage that can be exposed easily to daylight. Daylight PDT with methyl aminolevulinate (MAL) cream is a simple treatment for AK, almost painless, well tolerated and convenient, requiring minimal time in the clinic. Randomised controlled studies from northern Europe and Australia support the use of daylight PDT as an effective therapy for grade I and II AK on the face and scalp. There is sufficient daylight to conduct daylight PDT in Australia at any time of the year and during most weather conditions. Hence, daylight PDT with MAL can be included as an effective and well-tolerated new treatment option for the treatment of AK in Australia. These consensus recommendations provide guidelines for Australian clinicians on the use of daylight PDT in the treatment of diagnosed AK.
authors.affiliation: Dermatology, Central Sydney Dermatology, Sydney, New South Wales, Australia.
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: See
authors.affiliation: St George Dermatology and Skin Cancer Centre, Kogarah and Royal North Shore Hospital, Sydney, New South Wales, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Shumack
authors.affiliation: Department of Dermatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Dedee F
authors.initials: DF
authors.lastname: Murrell
authors.affiliation: Dermatology, Woden Dermatology, Canberra, Australian Capital Territory, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Rubel
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: Fernández-Peñas
authors.affiliation: Illawarra Dermatology and Laser Clinic, Wollongong Hospital, Wollongong, New South Wales, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Salmon
authors.affiliation: Dermatology, Burswood Dermatology, Perth, Western Australia, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hewitt
authors.affiliation: Dermatology, Skin and Cancer Foundation Inc., Melbourne, Victoria, Australia.|Department of Medicine (Dermatology), University of Melbourne, Melbourne, Victoria, Australia.|Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Foley
authors.affiliation: Dermatology, Specialist Connect and Veracity Clinical Research, Brisbane, Queensland, Australia.|Probity Medical Research Inc., Waterloo, Ontario, Canada.
authors.forename: Lynda
authors.initials: L
authors.lastname: Spelman
mesh_terms: D000622:Aminolevulinic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001315:Australia; D005148:Facial Dermatoses / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D013472:Sunlight; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid
keywords: actinic keratosis; daylight photodynamic therapy; metvix; solar keratosis