{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:14:03Z","timestamp":1789132443359,"version":"build-2803163510"},"reference-count":151,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Photodynamic therapy (PDT) is a minimally invasive treatment choice whose clinical success in dermatology relies on the interaction between a photosensitizer, light of an appropriate wavelength, and tissue oxygen, leading to reactive oxygen species generation and selective cytotoxicity. This narrative review summarizes contemporary mechanisms and clinical evidence supporting PDT across neoplastic, inflammatory, infectious, and esthetic indications. A comprehensive literature search included randomized trials when available, systematic reviews, meta-analyses, and guideline and consensus documents, complemented by mechanistic and translational studies relevant to clinical outcomes. In premalignant and neoplastic disease, strongest evidence supports field-directed PDT for actinic keratosis and high efficacy in Bowen\u2019s disease, with favorable cosmetic outcomes and acceptable recurrence patterns. PDT plays a more selective role in basal cell carcinoma, particularly superficial and selected nodular lesions, while its routine use as monotherapy in squamous cell carcinoma remains limited by higher recurrence. Beyond oncology, PDT shows expanding utility in acne via sebomodulatory and immunomodulatory effects, and in infectious dermatoses through broad antimicrobial activity and biofilm disruption with low resistance potential. Cosmetic applications, including photorejuvenation, benefit from protocol tailoring and combination strategies that enhance penetration and remodeling. Overall, PDT is evolving into an adaptable therapeutic framework best positioned within mechanism-oriented, multimodal algorithms.<\/jats:p>","DOI":"10.3390\/ijms27093960","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:34:42Z","timestamp":1777458882000},"page":"3960","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Photodynamic Therapy in Dermatology"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0117-346X","authenticated-orcid":false,"given":"Antonio","family":"Di Guardo","sequence":"first","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"},{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6764-6192","authenticated-orcid":false,"given":"Marco","family":"Virone","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2712-2792","authenticated-orcid":false,"given":"Umberto","family":"Gallo","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0662-5592","authenticated-orcid":false,"given":"Francesca","family":"Feresin","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Ricupito","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"De Carolis","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Coppolelli","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3828-0883","authenticated-orcid":false,"given":"Steven Paul","family":"Nistic\u00f2","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pellacani","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-951X","authenticated-orcid":false,"given":"Carmen","family":"Cantisani","sequence":"additional","affiliation":[{"name":"UOC of Dermatology, Department of Medical and Cardiovascular Sciences, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1562\/0031-8655(2001)074<0656:THOPAP>2.0.CO;2","article-title":"The history of photodetection and photodynamic therapy","volume":"74","author":"Ackroyd","year":"2001","journal-title":"Photochem. 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