Evidence map›Paper›PMID 42266064›Full record

Trial reportJournal of the European Academy of Dermatology and Venereology : JEADV2026

Simulated daylight versus conventional PDT for mild to moderate actinic keratoses: A randomized controlled trial.

Alexandra Sjöholm, Eva Backman, Maja Modin, Julia Fougelberg, Magdalena Claeson, John Paoli

Abstract readRandomized Controlled TrialComparative StudyEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the European Academy of Dermatology and Venereology : JEADV, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Simulated daylight versus conventional PDT for mild to moderate actinic keratoses: A randomized controlled trial.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alexandra SjöholmDepartment of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0002-8669-9291
Eva BackmanDepartment of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0002-0454-5644
Maja ModinDepartment of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Julia FougelbergDepartment of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0003-3433-5557
Magdalena ClaesonDepartment of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0001-5021-323X
John PaoliDepartment of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID https://orcid.org/0000-0003-1326-8535

Funding

Swedish governmental funding of clinical research (ALF) ALFGBG-1006260Swedish governmental funding of clinical research (ALF) ALFGBG-942629
6 · The paper itself

Abstract

backgroundConventional photodynamic therapy (C-PDT) with red light is an effective but painful treatment for patients with actinic keratoses (AKs). Simulated daylight PDT (SDL-PDT) is most likely less painful, but its effectiveness has not been thoroughly investigated.

objectivesTo evaluate if SDL-PDT is non-inferior to C-PDT in terms of effectiveness in the treatment of mild to moderate AKs. Additionally, pain perception, local skin reactions and patient preferences were assessed.

methodsThis single-centre, non-inferiority (-8% margin), randomized controlled trial included adults with symmetrically distributed mild to moderate AKs across one or more anatomical sites. These sites were randomly assigned to treatment with a single session of C-PDT on one half of the affected area and SDL-PDT on the other half, using 5-aminolevulinic acid hydrochloride as the prodrug. Pain during illumination was assessed using a 0-10 numeric rating scale (NRS). Patient preferences were recorded through self-report forms. Follow-up assessments were conducted at 3 months to evaluate early treatment failure and at 1 year to determine overall clearance rates.

resultsIn total, 69 participants with 1458 mild to moderate AKs were treated. Most lesions (89.9%) were located on the face and scalp and were diagnosed through clinical and dermoscopic evaluation. After 1 year, the clearance rate was 71.0% for SDL-PDT and 85.3% for C-PDT (p < 0.001), thus failing to demonstrate non-inferiority. Illumination was reported to be more painful during C-PDT (mean NRS score of 6.6) compared with SDL-PDT (mean NRS score of 0.8) (p < 0.001). One day after treatment, 98.3% of respondents expressed a preference for SDL-PDT.

conclusionsSDL-PDT showed lower clearance rates than C-PDT but caused significantly less pain. Although not supported as a primary treatment for AKs, SDL-PDT may be considered for patients prioritizing treatment tolerability within shared decision-making. This randomized controlled trial was registered at http://www.researchweb.org/ (Project ID: 264721).

Indexed as

Keratosis, ActinicPhotochemotherapyPhotosensitizing AgentsSunlightAgedAged, 80 and overAminolevulinic AcidFemaleHumansMaleMiddle AgedPain MeasurementPatient PreferenceRed LightAminolevulinic AcidPhotosensitizing Agentsactinic keratosisaminolevulinic acidphotodynamic therapyrandomized controlled trialsimulated daylight

Identifiers

PMID42266064
PMCPMC13613350

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.