title: A consensus on the use of daylight photodynamic therapy in the UK.
abstract: BACKGROUND
  Actinic keratoses (AKs) are a consequence of chronic exposure to ultraviolet radiation. Treatment of chronically photo-damaged skin and AKs is driven by risk of progression to squamous cell carcinoma, as well as for symptomatic relief. Conventional photodynamic therapy (c-PDT) is indicated when AKs are multiple or confluent and if patients respond poorly or are unable to tolerate other therapies. c-PDT is limited by the field size that can be treated in single sessions and can cause significant discomfort.
  
  
  OBJECTIVE
  Recent studies investigated daylight illumination to activate protoporphyrin IX and daylight-PDT (d-PDT) is now licensed in the UK for face and scalp AKs. A group of experts met to discuss application of d-PDT with methyl aminolevulinate (MAL) and develop a UK consensus statement, specific to UK weather conditions.
  
  
  METHODS
  The UK consensus recommendations were reached among eight experts, who reviewed recent studies on d-PDT, assessed UK meteorological data and discussed personal experiences of d-PDT for AKs.
  
  
  RESULTS
  Recommendations from these discussions provide guidance on d-PDT use, specifically regarding patient selection, therapeutic indications, when to treat, skin preparation, MAL application and daylight exposure for patients with AKs.
  
  
  CONCLUSIONS
  This UK expert consensus provides practical guidance for UK application of d-PDT.
authors: a Photobiology Unit, Department of Dermatology , Ninewells Hospital & Medical School , Dundee , UK.
authors: Sally
authors: S
authors: Ibbotson
authors: b Department of Dermatology , East Cheshire NHS Trust , Macclesfield , UK.
authors: Robin
authors: R
authors: Stones
authors: c Private Dermatology Practice , London , UK.|d Private Dermatology Practise , Oxford , UK.
authors: Jonathan
authors: J
authors: Bowling
authors: e Dermatology Department , The Royal Cornwall Hospital , Truro , UK.
authors: Sandra
authors: S
authors: Campbell
authors: f Primary Care Dermatology Society , Hatfield , UK.
authors: Stephen
authors: S
authors: Kownacki
authors: a Photobiology Unit, Department of Dermatology , Ninewells Hospital & Medical School , Dundee , UK.
authors: Muthu
authors: M
authors: Sivaramakrishnan
authors: g Beatson West of Scotland Cancer Centre , Glasgow , UK.
authors: Ronan
authors: R
authors: Valentine
authors: h Department of Dermatology , NHS Forth Valley , Stirling , UK.
authors: Colin A
authors: CA
authors: Morton
mesh_terms: D000622:Aminolevulinic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D032921:Consensus; D006801:Humans; D055623:Keratosis, Actinic / Q000188:drug therapy* / Q000473:pathology; D008027:Light; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011524:Protoporphyrins / Q000627:therapeutic use*; D006113:United Kingdom
chemical_list: D017319:Photosensitizing Agents; D011524:Protoporphyrins; C475457:methyl 5-aminolevulinate; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX
keywords: Actinic keratosis; daylight; methyl aminolevulinate; photodynamic therapy