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Aminolevulinic acid photodynamic therapy (PDT) is effective for actinic keratoses, but so far it has been found to be less successful for basal cell carcinomas (BCCs). Methyl aminolevulinate (mALA) offers improved skin penetration and improved specificity for neoplastic cells. In this industry-sponsored, European, multicenter, prospective study, 97 patients with 105 primary nodular BCCs larger than 6 mm were randomized to receive either mALA PDT using red light (570-670 nm) or surgical excision with 5-mm margins. The PDT protocol included gentle tumor débridement and application of mALA under occlusion for 3 hours followed by red light irradiation; a second treatment was given 1 week later and another, if necessary, at 3 months.
Three months…