Can daylight-PDT be performed indoor?

Natural DayLight-mediated PhotoDynamic Therapy (NDL-PDT) is an efficacious treatment option for thin actinic keratosis that offers advantages over conventional PDT in terms of tolerability and cost. It is now accepted that the minimum criteria required for effective NDL-PDT is a dose of 4 J/cm² with a treatment time of 2 hours and a minimum temperature of 10 °C, corresponding to a minimum illuminance of 11,000 lux. This value is easily achievable: 20,000 lux can be obtained during a typical overcast day at midday. It can reach 110,000 lux with a bright sunlight. However, it is limited to certain times of the year at our latitude. However rain and cold temperatures appear the main limitations of NDL-PDT. Greenhouses make possible to perform the illumination even in harsh weather conditions. Furthermore, it is difficult to install a greenhouse everywhere. Several solutions are now proposed to carry out indoor illumination so-called artificial white light or simulated daylight (SDL-PDT). Illumination sources installed at the ceiling of the treatment room is one option. Several lamp pairs can be combined to illuminate groups of patients simultaneously. A surgical theatre light can be used or dedicated systems using white LEDs can be used to deliver the required illumination dose. In conclusion, Indoor lightning (or simulated daylight: SDL-PDT or Artificial White Light: AWL) could offer an interesting alternative to NDL-PDT.

[1]  S. Ibbotson,et al.  Use of illuminance as a guide to effective light delivery during daylight photodynamic therapy in the U.K. , 2017, The British journal of dermatology.

[2]  J. Bowling,et al.  A consensus on the use of daylight photodynamic therapy in the UK , 2017, The Journal of dermatological treatment.

[3]  S. Ibbotson,et al.  Daylight photodynamic therapy in Scotland , 2017, Scottish medical journal.

[4]  J. McCavana,et al.  Artificial White Light vs Daylight Photodynamic Therapy for Actinic Keratoses: A Randomized Clinical Trial. , 2016, JAMA dermatology.

[5]  E. Chouela,et al.  Feasibility of daylight‐mediated photodynamic therapy for actinic keratosis throughout the year in Central and South America: a meteorological study , 2016, International journal of dermatology.

[6]  G. Vena,et al.  Daylight photodynamic therapy with methyl aminolaevulinate in patients with actinic keratoses: a preliminary experience in Southern Italy. , 2016, Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia.

[7]  D. Eisen,et al.  Daylight Photodynamic Therapy: What Is Known and What Is Yet to Be Determined , 2016, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[8]  E. Chouela,et al.  Daylight‐mediated photodynamic therapy for actinic damage in Latin America: consensus recommendations , 2016, Photodermatology, photoimmunology & photomedicine.

[9]  Jakob Heydenreich,et al.  Alternatives to Outdoor Daylight Illumination for Photodynamic Therapy—Use of Greenhouses and Artificial Light Sources , 2016, International journal of molecular sciences.

[10]  J. McCavana,et al.  Artificial white light photodynamic therapy of actinic keratosis: Commissioning and dosimetry , 2016 .

[11]  S. Shumack,et al.  Consensus recommendations on the use of daylight photodynamic therapy with methyl aminolevulinate cream for actinic keratoses in Australia , 2015, The Australasian journal of dermatology.

[12]  U. Reinhold,et al.  Simulated‐daylight photodynamic therapy with BF‐200 aminolaevulinic acid for actinic keratosis: assessment of the efficacy and tolerability in a retrospective study , 2015, The British journal of dermatology.

[13]  C. Zachary,et al.  Daylight photodynamic therapy: The Southern California experience , 2015, Lasers in surgery and medicine.

[14]  S. Mordon.  A commentary on the role of skin temperature on the effectiveness of ALA-PDT in Dermatology. , 2014, Photodiagnosis and photodynamic therapy.

[15]  L. Braathen.  Daylight photodynamic therapy in private practice in Switzerland: gain without pain. , 2012, Acta dermato-venereologica.

[16]  H. Wulf,et al.  Continuous activation of PpIX by daylight is as effective as and less painful than conventional photodynamic therapy for actinic keratoses; a randomized, controlled, single‐blinded study , 2008, The British journal of dermatology.

[17]  J. Moan,et al.  Temperature Effect on Accumulation of Protoporphyrin IX After Topical Application of 5-Aminolevulinic Acid and its Methylester and Hexylester Derivatives in Normal Mouse Skin¶ , 2002, Photochemistry and photobiology.

[18]  H. Erdem,et al.  Comparison of the Efficacy of Different Electrode Types of Interferential Current Therapy in the Treatment of Patients with Chronic Low Back Pain: A Randomized Controlled Single-Blinded Study , 2019, Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi.

[19]  C. Serra-Guillén,et al.  Spanish-Portuguese consensus statement on use of daylight-mediated photodynamic therapy with methyl aminolevulinate in the treatment of actinic keratosis. , 2015, Actas dermo-sifiliograficas.