Photodynamic therapy: treatment of choice for actinic cheilitis?

The major therapeutic approaches (5-fluorouracil, imiquimod, vermilionectomy, and CO(2) Laser ablation) for actinic cheilitis are aimed at avoiding and preventing a malignant transformation into invasive squamous cell carcinoma via destruction/removal of the damaged epithelium. Recently, photodynamic therapy (PDT) has been introduced as a therapeutic modality for epithelial skin tumors, with good efficacy/safety profile and good cosmetic results. Regarding actinic cheilitis, PDT could be considered a new therapeutic option? The target of our study was to evaluate the efficacy and tolerability of PDT in actinic cheilitis, using a methyl-ester of aminolevulinic acid (MAL) as topical photosensitizing agent and controlled the effects of the therapy for a 30-month follow-up period. MAL-PDT seems to be the ideal treatment for actinic cheilitis and other actinic keratosis, especially on exposed parts such as the face, joining tolerability and clinical efficacy with an excellent cosmetic outcome.