{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:34:30Z","timestamp":1790141670770,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T00:00:00Z","timestamp":1524009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Topical photodynamic therapy is an established treatment modality for various dermatological conditions, including actinic keratosis. In Europe, the approved protocols for photodynamic therapy of actinic keratosis involve irradiation with either an Aktilite CL 128 lamp or daylight, whereas irradiation with the Blu\u2010U illuminator is approved in the United States. Many other protocols using irradiation by a variety of light sources are also clinically efficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This paper aims to compare 10 different protocols with clinically proven efficacy for photodynamic therapy of actinic keratosis and the available spectral irradiance of the light source. Effective irradiance, effective light dose, and local damage are compared. We also investigate whether there is an association between the complete response rate at 3 months and the effective light dose or local damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The effective irradiance, also referred to as protoporphyrin IX\u2010weighted irradiance, is obtained by integrating the spectral irradiance weighted by the normalized absorption spectrum of protoporphyrin IX over the wavelength. Integrating the effective irradiance over the irradiation time yields the effective light dose, which is also known as the protoporphyrin IX\u2010weighted light dose. Local damage, defined as the total cumulative singlet oxygen molecules produced during treatment, is estimated using mathematical modeling of the photodynamic therapy process. This modeling is based on an iterative procedure taking into account the spatial and temporal variations in the protoporphyrin IX absorption spectrum during treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The protocol for daylight photodynamic therapy on a clear sunny day, the protocol for daylight photodynamic therapy on an overcast day, the photodynamic therapy protocol for a white LED lamp for operating rooms and the photodynamic therapy protocol for the Blu\u2010U illuminator perform better than the six other protocols\u2014all involving red light illumination\u2014in terms of both effective light dose and local damage. However, no association between the complete response rate at 3 months and the effective light dose or local damage was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Protocols that achieve high complete response rates at 3 months and low pain scores should be preferred regardless of the effective light dose and local damage. Lasers Surg. Med. 50:576\u2013589, 2018. \u00a9 2018 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.22827","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T10:23:47Z","timestamp":1524047027000},"page":"576-589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Comparison of 10 efficient protocols for photodynamic therapy of actinic keratosis: How relevant are effective light dose and local damage in predicting the complete response rate at 3 months?"],"prefix":"10.1002","volume":"50","author":[{"given":"Anne\u2010Sophie","family":"Vignion\u2010Dewalle","sequence":"first","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1189\u2013ONCO\u2010THAI\u2014Image Assisted Laser Therapy for Oncology Lille F\u201059000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Baert","sequence":"additional","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1189\u2013ONCO\u2010THAI\u2014Image Assisted Laser Therapy for Oncology Lille F\u201059000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Thecua","sequence":"additional","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1189\u2013ONCO\u2010THAI\u2014Image Assisted Laser Therapy for Oncology Lille F\u201059000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Lecomte","sequence":"additional","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1189\u2013ONCO\u2010THAI\u2014Image Assisted Laser Therapy for Oncology Lille F\u201059000 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Vicentini","sequence":"additional","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1189\u2013ONCO\u2010THAI\u2014Image Assisted Laser Therapy for Oncology Lille F\u201059000 France"},{"name":"Department of Dermatology CHU Lille Lille F\u20105900 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Abi\u2010Rached","sequence":"additional","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1189\u2013ONCO\u2010THAI\u2014Image Assisted Laser Therapy for Oncology Lille F\u201059000 France"},{"name":"Department of Dermatology CHU Lille Lille F\u20105900 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Mortier","sequence":"additional","affiliation":[{"name":"Univ. 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