Human Papillomavirus Vaccination and Actinic Keratosis Burden: The VAXAK Randomized Clinical Trial.

Importance: The substantial morbidity and socioeconomic costs associated with actinic keratosis (AK) management represent major public health concerns. Anecdotal evidence suggests that human papillomavirus (HPV) vaccination may offer therapeutic and preventive effects against AK and keratinocyte carcinomas (KCs).

Objective: To investigate the effect of HPV vaccination on burden of disease in immunocompetent patients with high numbers of AK.

Is the benefit of sequential 5-fluorouracil and daylight photodynamic therapy versus daylight photodynamic therapy alone sustained over time? - 12-month follow-up of a randomized controlled trial.

Background: Since recurrences and new AKs commonly are observed after treatment long-term effects of field-directed therapies for AKs are crucial. Thus, we evaluated the 6- and 12-month efficacy and satisfaction of sequential topical 5-fluorouracil (5-FU) and daylight PDT (dPDT) with dPDT alone.

Methods: In a randomized intra-individual study patients with multiple AKs in the face and scalp were treated with 4 % 5-fluorouracil cream twice daily for 7 days on one side of the scalp/face, followed by dPDT on both sides.

Vascular Characteristics of Treatment-resistant and -responsive Actinic Keratosis Identified with Dynamic Optical Coherence Tomography.

Treatment-resistant actinic keratosis (AK) is of concern in clinical practice, often requiring retreatment. Microvascular assessments might help differentiate treatment-resistant from treatment-responsive AKs, enabling targeted treatment. Using dynamic optical coherence tomography, AK vascularization was investigated following daylight photodynamic therapy, comparing treatment-resistant with cleared AKs.

Prebiotic and panthenol-containing dermocosmetic improves tolerance from artificial daylight photodynamic therapy: A randomized controlled trial in patients with actinic keratosis.

Introduction & Objectives: Treatment with daylight photodynamic therapy (dPDT) of actinic keratosis (AK) is associated with local skin reactions (LSR), which may affect patients' quality of life and treatment acceptability. This study explores the potential of a prebiotic and panthenol-containing Dermocosmetic Cream (DC) to enhance tolerance and mitigate post-dPDT induced LSR in the treatment of AKs.

Materials & Methods: This randomized controlled, intra-individual trial included 20 patients with ≥10 AKs in two symmetrical areas on their face or décolleté, treated with a single session of artificial dPDT.

A European Consensus on the Consistent Use of the Term "Keratinocyte Cancer".

Keratinocyte-derived skin cancers comprise basal cell carcinoma, squamous cell carcinoma, its precursor actinic keratosis, and Bowen's disease. Historically, this group of neoplasms has been subsumed under the term non-melanoma skin cancer. However, the term non-melanoma skin cancer can be misleading and lacks precision.

Vascular feature identification in actinic keratosis grades I-III using dynamic optical coherence tomography with automated, quantitative analysis.

Clinical grading of actinic keratosis (AK) is based on skin surface features, while subclinical alterations are not taken into consideration. Dynamic optical coherence tomography (D-OCT) enables quantification of the skin´s vasculature, potentially helpful to improve the link between clinical and subclinical features. We aimed to compare microvascular characteristics across AK grades using D-OCT with automated vascular analysis.

An Explorative Study on Calcium Electroporation for Low-risk Basal Cell Carcinoma.

In electrochemotherapy, permeabilization of the cell membrane by electric pulses increases the anti-tumour effect of chemotherapeutics. In calcium electroporation, chemotherapy is replaced by calcium chloride with obvious benefits. This study explores the effect and underlying mechanisms of calcium electroporation on basal cell carcinomas using either high- or low-frequency electroporation.

Pre-treatment with topical 5-fluorouracil increases the efficacy of daylight photodynamic therapy for actinic keratoses - A randomized controlled trial.

Background: Daylight photodynamic therapy (dPDT) and topical 5-fluorouracil (5-FU) are each effective treatments for thin grade I actinic keratosis (AKs), but less so for thicker grade II-III AKs. Prolonged topical treatment regimens can be associated with severe skin reactions and low compliance. This study compares the efficacy of sequential 4 % 5-FU and dPDT with dPDT monotherapy for multiple actinic keratoses.

A one-time pneumatic jet-injection of 5-fluorouracil and triamcinolone acetonide for treatment of hypertrophic scars-A blinded randomized controlled trial.

Background: Patients with hypertrophic scars (HTS) risk reduced quality of life due to itching, pain, poor cosmesis, and restriction of movement. Despite good clinical efficacy, patients are often reluctant to undergo repeated needle injections due to pain or needle phobia.

Objectives: To evaluate the applicability of needle-free pneumatic jet injection (PJI) and assess changes in hypertrophic scars following a single PJI treatment with 5-fluorouracil (5-FU) and triamcinolone acetonide (TAC).

Treatment of Familial Benign Chronic Pemphigus With Superficial Radiotherapy.

Importance: Hailey-Hailey disease (HHD) is a chronic genodermatosis with recurrent vesicles and erosions mainly in the intertriginous areas. Hailey-Hailey disease severely affects patient quality of life. Standard treatments attempt to control the flares, but often do not result in long-term remission of the disease.

Use of 5-Aminolevulinic Acid and Daylight Photodynamic Therapy for the Treatment of Actinic Keratoses.

Background: Photodynamic therapy (PDT) is an effective modality for the treatment of actinic keratoses (AKs). The use of methyl aminolevulinate with daylight PDT (D-PDT) has quickly gained popularity internationally because of its tolerability and high levels of safety and efficacy. However, there is a paucity of studies on the use of D-PDT with 5-aminolevulinic acid (ALA).

Pretreatment with 5-Fluorouracil Cream Enhances the Efficacy of Daylight-mediated Photodynamic Therapy for Actinic Keratosis.

The efficacy of photodynamic therapy (PDT) with methyl aminolevulinate is reduced when treating actinic keratosis (AK) on the extremities in comparison with the face and scalp. Studies indicate that PDT efficacy can be improved by combining PDT with other treatment modalities. This randomized intra-individual study investigated whether pretreatment with topical 5% 5-fluorouracil (5-FU) enhanced the treatment efficacy of daylight-mediated PDT in 24 patients with AKs on the hands.

Short-term chemical pretreatment cannot replace curettage in photodynamic therapy.

Background: Guidelines for photodynamic therapy (PDT) recommend pretreatment with curettage/debulking to enhance intracellular formation of protoporphyrin IX (PpIX). However, studies suggest that new chemical pretreatment procedures may replace curettage/debulking.

Purpose: To investigate how pretreatment with curettage and two combination ointments containing calcipotriol/betamethasone and salicylic acid/betamethasone affect PpIX fluorescence after the application of methyl aminolevulinate MAL and 5-aminolevulinic acid (BF-200 ALA).

Is the thin layer of methyl aminolevulinate used during photodynamic therapy sufficient?

Background: If the recommended 1.0 mm layer of methyl aminolevulinate (MAL) is used during photodynamic therapy (PDT) of large areas with multiple actinic keratoses (AK) huge amounts of cream are needed.

Objectives: To report the amount of MAL used for PDT of AK and basal cell carcinomas (BCC) in daily routine.

Update on photodynamic treatment for actinic keratosis.

Photodynamic therapy (PDT) is an attractive treatment option for actinic keratoses (AKs), as large skin areas can be treated with high response rates and superior cosmetic outcome. The efficacy of 5-aminolevulinic acid (ALA)-PDT and methyl aminolevulinate (MAL)-PDT for AK has been proven in multiple studies, and this treatment is recommended in numerous consensus works and therapy guidelines. Moreover, a self-adhesive ALA patch has been approved for the PDT of AK.

Continuous ultra-low-intensity artificial daylight is not as effective as red LED light in photodynamic therapy of multiple actinic keratoses.

Background/purpose: Daylight-mediated photodynamic therapy (PDT) is a simple and tolerable treatment of nonmelanoma skin cancer. It is of interest which light intensity is sufficient to prevent accumulation of protoporphyrin IX (PpIX) and effectively treat actinic keratoses (AKs). We compared the efficacy of PDT with light-emitting diode (LED) to daylight-mediated PDT with very low-intensity artificial daylight ('daylight') in the treatment of multiple AKs in the face or scalp.

Skin pigmentation kinetics after exposure to ultraviolet A.

Multiple exposures to ultraviolet radiation (UVR) are the norm in nature and phototherapy. However, studies of the kinetics of pigmentation following UVA exposure have included only fair-skinned persons. The aim of this study was to investigate steady-state pigmentation and fading in 12 Scandinavians and 12 Indians/Pakistanis after 6 and 12 exposures on the back using broadband UVA and UVA1 with equal sub-minimal melanogenic doses (individually predetermined).

Cold water and pauses in illumination reduces pain during photodynamic therapy: a randomized clinical study.

Pain is the main acute adverse event during photodynamic therapy of skin lesions. The objective of this randomized study was to evaluate the pain-relieving effect of pauses and cooling during illumination. Twenty-four patients with actinic keratoses were treated with photodynamic therapy in two symmetrical areas and cooled with either cold-water-spray or cold-water-pack (CoolPack).

Skin pigmentation kinetics after UVB exposure.

There have been few previous studies of the kinetics of pigmentation following ultraviolet B (UVB) exposure, and these have included only fair-skinned persons. The current study investigated pigmentation increase to steady state and fading in 12 Scandinavians and 12 Indians/Pakistanis. Over a period of 3 weeks the subjects were UV-irradiated 6 times on the right side of the back and 12 times on the left side using a Solar Simulator and narrowband UVB with equal sub-Minimal Melanogenesis Doses (individually predetermined).

Long-pulsed dye laser versus long-pulsed dye laser-assisted photodynamic therapy for acne vulgaris: A randomized controlled trial.

Background: Long-pulsed dye laser (LPDL)-assisted photodynamic therapy has been suggested to be superior to laser alone for acne vulgaris but no evidence is available.

Objective: To evaluate the efficacy and safety of LPDL alone versus LPDL in photodynamic therapy with methylaminolevulinic acid (MAL-LPDL) for acne vulgaris.

Methods: Fifteen patients received a series of 3 full-face LPDL treatments and half-face prelaser MAL treatments; the latter being randomly assigned to the left or right side.

Transepidermal water loss after photodynamic therapy, UVB radiation and topical corticosteroid is independent of inflammation.

Background/purpose: Photodynamic therapy (PDT) and ultraviolet radiation cause an inflammatory reaction of the skin. This may lead to disruption of the skin barrier function. We examined the acute effect of PDT and short-wave ultraviolet radiation (UVB) on the barrier function of the epidermis.