Understanding the Efficacy of Photodynamic Therapy in Comparison to Topical Therapies in Treating actinic Keratosis in those at Increased Sun Exposure Risk

Introduction: Actinic keratoses are precancerous skin lesions that arise secondary to increased sun exposure. These lesions have a propensity to transform into non-melanoma skin cancers, mainly squamous cell carcinoma, if left untreated. There are a multitude of different treatment options for the prevention and clearance of these lesions. Among these options is photodynamic therapy (PDT). The purpose of this paper is to investigate the effectiveness of PDT when compared to other options for AK treatment. Methods: A search was conducted using PubMed for studies to analyze the efficacy of PDT when compared to other treatment options. 3 articles were selected for use in this review. Results: In 2 of the 3 selected studies; PDT was shown to have superior efficacy when compared to other treatment options in terms of both prevention and clearance rate of AKs. In the remaining study, PDT was ranked 3rd in patient complete clearance and lesion specific clearance, ranking just behind cryosurgery and topical agent, Ingenol Mebutate. PDT was shown to be superior to placebo in all 3 of the studies. In one study, the prophylactic capabilities were emphasized and recognized as greater than alternative treatment options in preventing formation of new AKs in photodamaged areas of skin. Side effects of the treatment were limited in each, consisting mainly of skin sensitivity after treatment and minor pain reported during treatment. Conclusion: PDT is an efficacious treatment option when determining what the best approach is to not only treating but preventing AKs from forming and transforming into skin cancer. The frequency of necessary treatments needs to be further investigated to determine how often, and for how long treatments need to continue to see positive clinical results.