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Photodynamic therapy is a noninvasive therapy for nonhyperkeratotic actinic keratoses and basal-cell carcinoma. Photodynamic therapy involves the activation of a photosensitizing drug by visible light to produce activated oxygen species within target cells, resulting in their destruction. Commonly used topical photosensitizers are aminolevulinic acid (ALA) and the methyl ester of ALA (MAL), which act as precursors of the endogenous photosensitizer protoporphyrin IX (PpIX). In addition to its therapeutic uses, fluorescence emitted by MAL-induced PpIX may be useful in providing a fluorescence diagnosis of cutaneous lesions. This permits the detection of otherwise occult areas of abnormal skin (Panel A). Tumor margins . . . [Full Text of this Article] |