{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:40:53Z","timestamp":1784868053685,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T00:00:00Z","timestamp":1387238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002468","name":"Dong-A university","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002468","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Photodynamic therapy (<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content>) with methyl aminolevulinate (<jats:styled-content style=\"fixed-case\">MAL<\/jats:styled-content>) is effective for treating multiple actinic keratoses (<jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s). Ablative fractional laser (<jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>) creates vertical channels that may facilitate <jats:styled-content style=\"fixed-case\">MAL<\/jats:styled-content> delivery and improve <jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy of <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010assisted <jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content>) in treating facial <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s in Korean patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective randomized non\u2010blinded trial initially evaluated 271 facial <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s in 45 patients. All patients underwent one session of <jats:styled-content style=\"fixed-case\">MAL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> using a red light\u2010emitting diode lamp at 37\u00a0J\/cm<jats:sup>2<\/jats:sup>, and 23 patients with 135 AK lesions were randomly assigned to pre\u2010treatment with a 2940\u2010nm ablative fractional erbium:Yag laser. Patients were followed up at 1, 2 and 4\u00a0weeks and every month until 6 and 12\u00a0months post\u2010treatment. Response, adverse events, cosmetic outcome and patient satisfaction were documented. Finally, a total of 236 facial <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s in 40 patients were enrolled and analysed in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> was significantly more effective than <jats:styled-content style=\"fixed-case\">MAL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> at treating all <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> grades (86.9% vs. 61.2%; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001). The efficacy of <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> was most pronounced in treating Olsen grade <jats:styled-content style=\"fixed-case\">III AK<\/jats:styled-content>s (69.4% vs. 32.5%; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001). <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> also showed a lower lesion recurrence rate than <jats:styled-content style=\"fixed-case\">MAL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> (9.7% vs. 26.6%; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.004). Excellent or good cosmetic outcome was reported in &gt;90% cases. Erythema and hyperpigmentation intensities were higher in the <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> group (<jats:italic>P\u00a0<\/jats:italic>&gt;<jats:italic>\u00a0<\/jats:italic>0.05). Side\u2010effects were more frequent in the <jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> group, but these were mild and well tolerated (<jats:italic>P\u00a0<\/jats:italic>&gt;<jats:italic>\u00a0<\/jats:italic>0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">FL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> is effective for treating <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s, especially moderate\u2010to\u2010thick lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.12334","type":"journal-article","created":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T07:46:39Z","timestamp":1387266399000},"page":"1529-1539","source":"Crossref","is-referenced-by-count":71,"title":["Fractional erbium: YAG laser\u2010assisted photodynamic therapy for 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