{"doi":"10.1002/ski2.226","title":"Equivalent Efficacy of Indoor Daylight and Lamp-Based 5-Aminolevulinic Acid Photodynamic Therapy for Treatment of Actinic Keratosis","abstract":"Background: Photodynamic therapy (PDT) is widely used as a treatment for actinic keratoses (AK), with new sunlight-based regimens proposed as alternatives to lamp-based treatments. Prescribing indoor daylight activation could help address the seasonal temperature, clinical supervision, and access variability associated with outdoor treatments. Objective: To compare the AK lesion clearance efficacy of indoor daylight PDT treatment (30 min of 5-aminolevulinic acid (ALA) pre-incubation, followed by 2 h of indoor sunlight) versus a lamp-based PDT treatment (30 min of ALA preincubation, followed by 10 min of red light). Methods: A prospective clinical trial was conducted with 41 patients. Topical 10% ALA was applied to the entire treatment site (face, forehead, scalp). Patients were assigned to either the lamp-based or indoor daylight treatment. Actinic keratosis lesion counts were determined by clinical examination and recorded for pre-treatment, 1-month, and 6-month follow-up visits. Results: There was no statistical difference in the efficacy of AK lesion clearance between the red-lamp (1-month clearance = 57 ± 17%, 6-month clearance = 57 ± 20%) and indoor daylight treatment (1-month clearance = 61 ± 19%, 6-month clearance = 67 ± 20%). A 95% confidence interval of the difference of the means was measured between -4.4% and 13.4% for 1-month, and -2.2% and +23.6% for 6-month timepoints when comparing the indoor daylight to the red-lamp treatment, with a priori interval of equivalence of ±20%. Limitations: Ensuring an equivalent dose between the indoor and lamp treatment cohorts limited randomisation since it required performing indoor daylight treatments only during sunny days. Conclusion: Indoor-daylight PDT provided equivalent AK treatment efficacy to a lamp-based regimen while overcoming temperature limitations and UV-block sunscreen issues associated with outdoor sunlight treatments in the winter. Clinical trial registration: Clinicaltrials.gov listing: NCT03805737.","journal":"Skin Health and Disease","year":2023,"id":347620,"datarank":0.445343670920206,"base_score":2.4849066497880004,"endowment":2.4849066497880004,"self_citation_contribution":0.37273599746820013,"citation_network_contribution":0.07260767345200583,"self_endowment_contribution":0.37273599746820013,"citer_contribution":0.07260767345200583,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":9,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9579,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03805737"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":312081,"name":"Ethan P. M. LaRochelle","orcid":"0000-0002-7883-9987","position":1,"is_corresponding":false},{"id":1089972,"name":"Marie‐Christine P. Fahrner","orcid":null,"position":2,"is_corresponding":false},{"id":348315,"name":"Jennifer A. Emond","orcid":"0000-0001-8684-7330","position":3,"is_corresponding":false},{"id":377168,"name":"Kimberley S. Samkoe","orcid":"0000-0002-8234-2308","position":4,"is_corresponding":false},{"id":250016,"name":"Brian W. Pogue","orcid":"0000-0002-9887-670X","position":5,"is_corresponding":false},{"id":400068,"name":"Michael Chapman","orcid":"0000-0003-4424-0156","position":6,"is_corresponding":false},{"id":630819,"name":"Alberto J. Ruiz","orcid":"0000-0002-0577-369X","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T01:12:01.859977Z","pmid":"37538332","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}