Nation wide survey on the use of photodynamic therapy among Australian dermatologists

Photodynamic therapy (PDT) is a non-surgical treatment option for actinic keratoses (AK) and some superficial non-melanoma skin cancers. A Survey Monkey questionnaire assessed the experience and utilization of PDT amongst Australasian Dermatologists.
Of the 408 surveyed, 76 (18.6%) provided valid responses. The majority of respondents (76%) utilized PDT in their practice whilst 7% referred patients for PDT. The number of patients treated by each dermatologist varied from 1 to 350 per year, with an average of 62.
Only 63% of those performing PDT had undergone PDT training. Approximately 25% indicated their PDT practice would be greater if they had received formal training.
Approximately 50% incorporated both methyl aminolaevulinic acid (m-ALA) and 5-ALA in their practice with 41% using only m-ALA and 7% only 5-ALA. Aktilight LED red light source was frequently used (87%) followed by daylight (48%) and IPL (14%). The commonest indication was large field AK (54%) followed by superficial BCC (23%). The commonest site for PDT was the H zone of the face. 91% respondents prepared lesions with curettage prior to PDT.
Approximately 93% used analgesia during PDT, commonest being local anesthetic injection, followed by fan, cold air blower and ice packs.
Choosing PDT over other non-surgical or surgical modalities was mainly driven by patient preference. Almost half stated PDT was simpler than alternatives and provided better cosmetic outcomes.
PDT appears to be a commonly used treatment modality by Australian dermatologists, however the study is limited by the relatively low overall response rate.

Dr. Nisansala Nagodavithana