Expert consensus-based recommendations on the use of photodynamic therapy in actinic keratosis patients

JAAD International Pub Date : 2025-03-13 DOI:10.1016/j.jdin.2024.11.011

Vishal A. Patel MD , Sarah T. Arron MD , Brian Berman MD, PhD , M. Shane Chapman MD, MBA , Anokhi Jambusaria-Pahlajani MD , George Martin MD , Anthony M. Rossi MD , Todd Schlesinger MD , Nathalie C. Zeitouni MDCM , Neal Bhatia MD

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Abstract

Background

Current actinic keratosis (AK) treatment guidelines are controversial and incomplete, leaving an unmet need for clearer and more in-depth guidance on the usage of photodynamic therapy (PDT) in AKs.

Objective

To gain consensus on the use of PDT for AKs using a modified Delphi method.

Methods

Consensus statements were developed after a literature review of topics surrounding PDT and AKs. Ten panelists voted through electronic questionnaires rating each statement on a three-point Likert-type scale: strongly agree, agree, and disagree. Consensus was established when ≥70% of panelists strongly agreed on the statement. Statements that did not meet the threshold were revised after each round of voting and sent out for the next round of voting. A virtual meeting was held after 2 rounds of voting to discuss outstanding statements.

Results

Three modified Delphi rounds were completed in total and 1 virtual meeting was held. All 10 experts responded to all rounds of voting. A total of 55 statements established consensus with the ≥70% majority requirement necessary.

Limitations

Recommendations are based on expert opinions.

Conclusion

The results from this consensus panel are intended to bridge gaps in the existing guidelines and will continue to evolve.

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基于专家共识的光动力疗法在光化性角化患者中的应用建议

目前的光化性角化病（AK）治疗指南存在争议且不完整，因此需要更清晰、更深入地指导光动力治疗（PDT）在AK中的应用。目的采用改进的德尔菲法对ak进行PDT检测，获得共识。方法：在对PDT和ak相关主题进行文献综述后，形成共识声明。10位小组成员通过电子问卷投票，按照李克特式的3分制对每个陈述进行打分：非常同意、同意和不同意。当≥70%的小组成员强烈同意该陈述时，建立共识。未达到阈值的声明在每轮投票后进行修订，并发出进行下一轮投票。经过两轮投票，召开了虚拟会议，讨论未完成的发言。结果共完成3轮修改德尔菲，召开1次虚拟会议。所有10位专家都对每一轮投票做出了回应。共有55项声明建立了≥70%多数要求的共识。建议是基于专家意见。结论：该共识小组的结果旨在弥合现有指南中的差距，并将继续发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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