{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:40:52Z","timestamp":1784868052848,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"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":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>D\u00e9collet\u00e9 photodamage is a common condition typically treated with light and energy\u2010based devices. This study investigated the efficacy and safety of a fractional 1,927\u2009nm thulium laser (TL) alone and combined with photodynamic therapy (PDT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design\/Materials and Methods<\/jats:title><jats:p>In a 12\u2010week follow\u2010up study, participant d\u00e9collet\u00e9s were divided into four treatment areas and randomized to receive a single treatment with field\u2010directed TL, PDT, combination TL\u2010PDT, or lesion\u2010directed curettage control. All actinic keratoses (AKs) underwent lesion\u2010directed curettage before randomization. TL was delivered at 20\u2009mJ\/mb, 500\u2009mJ\/cm<jats:sup>2<\/jats:sup> fluence, 5\u2009W, and 8 (<jats:italic>n<\/jats:italic>\u2009=\u20096 pts.) or 16 (<jats:italic>n<\/jats:italic>\u2009=\u20096 pts.) passes. PDT was performed with 16% methyl aminolevulinate (MAL) creme incubated for 3\u2009h, followed by red light\u2010emitting diode light at 37\u2009J\/cm<jats:sup>2<\/jats:sup>. Outcome measures included clinical assessment of overall photodamage and specific subcomponents, assisted by optical coherence tomography (OCT) imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve women with moderate to severe photodamage on the d\u00e9collet\u00e9 and a cumulative total of 184 thin grade I AKs were included. Field\u2010directed treatments TL and combination TL\u2010PDT equally improved the overall photodamage, mottled pigmentation, and rhytides compared with lesion\u2010directed control (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The skin texture improved by TL alone and was further improved by combining TL and PDT (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Median AK complete responses were similar for field\u2010directed interventions TL\u2010PDT (100%), TL (90%), PDT (82%), and lesion\u2010directed curettage control (52%) (<jats:italic>P<\/jats:italic>\u2009=\u20090.464). Patients presented with mild local skin responses, slightly more pronounced when combining TL with PDT versus individual treatments (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). No scarring or adverse events were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The 1,927\u2009nm fractional thulium laser is an effective, tolerable, and safe field\u2010directed treatment for d\u00e9collet\u00e9 photodamage. Provided alone, TL proved to be as effective as combined TL\u2010PDT for overall photodamage, while a greater improvement in skin texture was achieved using TL and PDT in combination. Lasers Surg. Med. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.23194","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T19:48:19Z","timestamp":1575316099000},"page":"44-52","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Fractional 1,927\u2009nm Thulium Laser Plus Photodynamic Therapy Compared and Combined for Photodamaged D\u00e9collet\u00e9 Skin: A Side\u2010by\u2010Side Randomized Controlled Trial"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1845-1224","authenticated-orcid":false,"given":"Kristoffer","family":"Hendel","sequence":"first","affiliation":[{"name":"Department of Dermatology Copenhagen University Hospital Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 17 2400 Copenhagen 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