{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:02:40Z","timestamp":1789470160768,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical Research Institute HUCH"},{"name":"Helsinki University Hospital Inflammation Centre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Actinic field cancerization is considered a chronic and relapsing condition. Thus, long-term clearance and prevention of cutaneous squamous cell carcinoma should be the fundamental goals of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare long-term outcomes of two novel field treatments for actinic keratosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an investigator-initiated intraindividual randomized controlled and evaluator-blinded trial. Fractional laser-assisted artificial or natural daylight photodynamic therapy was compared to daylight photodynamic therapy alone. The study was designed as a split-head comparison of 60 patients with at least two actinic keratoses of the head, with a 2-year follow-up. The study was registered at ClinicalTrials.gov (NCT05456334).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The intention-to-treat analysis showed significantly higher lesion-specific 2-year sustained clearance with laser-assisted treatment (56.3%, 147 of 261) than with daylight photodynamic therapy alone (43.0%, 108 of 251; P = 0.003). Additionally, 46% (26 of 57) of patients achieved 2-year sustained partial clearance with laser-assisted treatment, compared with 32% (18 of 57) with daylight photodynamic therapy alone (P = 0.06). Correspondingly, 16% (9 of 57) vs. 7% (4 of 57) of patients achieved sustained complete clearance (P = 0.07). No squamous cell carcinomas developed on the treatment field, and in total there were three occurrences of Bowen disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Laser-assisted daylight photodynamic therapy appears to achieve higher long-term sustained clearance and may also be superior in the long term compared with daylight photodynamic therapy alone in the treatment of actinic keratosis of all grades.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llag168","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T11:27:44Z","timestamp":1776166064000},"source":"Crossref","is-referenced-by-count":1,"title":["Laser-assisted vs. conventional daylight photodynamic therapy for actinic keratosis: a 2-year randomized evaluator-blinded half-side comparative trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2707-0861","authenticated-orcid":false,"given":"Vivian","family":"Lindholm","sequence":"first","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Salmivuori","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Hahtola","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5471-5894","authenticated-orcid":false,"given":"Alexander","family":"Salava","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsi","family":"Isoherranen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki , Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026091506061055700_llag168-B1","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1111\/jgs.16706","article-title":"The high prevalence of skin diseases in adults aged 70 and older","volume":"68","author":"Sinikumpu","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"2026091506061055700_llag168-B2","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.jaad.2020.03.126","article-title":"Field cancerization: definition, epidemiology, risk factors, and outcomes","volume":"83","author":"Willenbrink","year":"2020","journal-title":"J Am Acad Dermatol"},{"key":"2026091506061055700_llag168-B3","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/0190-9622(91)70113-G","article-title":"A double-blind, vehicle-controlled study evaluating masoprocol cream in the treatment of actinic keratoses on the head and neck","volume":"24","author":"Olsen","year":"1991","journal-title":"J Am Acad Dermatol"},{"key":"2026091506061055700_llag168-B4","first-page":"e1","article-title":"Methods and results report \u2013 evidence and consensus-based (S3) guidelines for the treatment of actinic keratosis \u2013 International League of Dermatological Societies in cooperation with the European Dermatology Forum","volume":"29","author":"Werner","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026091506061055700_llag168-B5","doi-asserted-by":"crossref","first-page":"4736","DOI":"10.3390\/jcm10204736","article-title":"How to assess the efficacy of interventions for actinic keratosis? 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