PDT has produced a reduction of AK lesions using a wide variety of light sources, and occluded incubation periods with 5-ALA. A 20% concentration has been used most frequently, but other concentrations (10%, 30%) have also been used effectively. However, in the US only a 20% ALA HCl topical solution used in conjunction with the blue light PDT illuminator is approved for the treatment of AK. Although the healing process is somewhat lengthy, it is comparable to the events experienced by patients following 5-FU and other topical regimens. As treatment takes place over 2 days, rather than many weeks with topical formulations, PDT may be more convenient for the patient willing to undergo the process; however, long-term efficacy has not been established. Moreover, PDT has not been effective in treating hyperkeratotic lesions.
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