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Recent clinical, histological and immunohistochemical observations have shown that c\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> with methyl aminolevulinate (<jats:styled-content style=\"fixed-case\">MAL<\/jats:styled-content>) may also partially reverse the signs of photodamage. However, pain and the need for special light source equipment are limiting factors for its use, especially in the treatment of large areas. More recently, daylight <jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content>) has been shown to be similar to c\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> in the treatment of <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>, nearly painless and more convenient to perform. To establish consensus on recommendations for the use of <jats:styled-content style=\"fixed-case\">MAL DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> in patients with large\u2010scale photodamaged skin. The expert group was comprised of eight dermatologists. Consensus was developed based on the personal experience of the experts in c\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content>, and results of an extensive literature review. <jats:styled-content style=\"fixed-case\">MAL DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> for large areas of photodamaged skin was evaluated and recommendations based on broad clinical experience were provided. As supported by evidence\u2010based data from multicentre studies conducted in Australia and Europe, the authors defined the concept of \u2018actinic field damage\u2019 which refers to photodamage associated with actinic epidermal dysplasia, and provide comprehensive guidelines for the optimal use of <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> in the treatment of actinic field damage. The authors concluded that <jats:styled-content style=\"fixed-case\">MAL DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> has a similar efficacy to c\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> at 3\u2010month (lesion complete response rate of 89% vs. 93% in the Australian study and 70% vs. 74% in the European study (95% C.I.\u00a0=\u00a0[\u22126.8;\u22120.3] and [\u22129.5;2.4] respectively) and 6\u2010month follow\u2010ups (97% maintenance of complete lesion response) in the treatment of <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s. The authors agree that <jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PDT<\/jats:styled-content> is not only efficacious but also nearly pain\u2010free and easy to perform, and therefore results in high patient acceptance especially for the treatment of areas of actinic field damage.<\/jats:p>","DOI":"10.1111\/jdv.13327","type":"journal-article","created":{"date-parts":[[2015,11,10]],"date-time":"2015-11-10T00:01:20Z","timestamp":1447113680000},"page":"8-15","source":"Crossref","is-referenced-by-count":39,"title":["Daylight photodynamic therapy with <scp>MAL<\/scp> cream for large\u2010scale photodamaged skin based on the concept of \u2018actinic field damage\u2019: recommendations of an international expert group"],"prefix":"10.1111","volume":"30","author":[{"given":"W.G.","family":"Philipp\u2010Dormston","sequence":"first","affiliation":[{"name":"Hautzentrum Koeln (Cologne Dermatology) Cologne 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