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The article offers guidelines for topical photodynamic therapy (PDT) released by the British Association of Dermatologists and British Photodermatology Group. It offers overview of the purpose and scope of the guideline aimed at providing updated evidence-based recommendations for use of PDT. It also notes that the recommendation was developed for implementation in the National Health Service in Great Britain.

Summary: Background: Topical photodynamic therapy (PDT) is widely used to treat superficial nonmelanoma skin cancer and dysplasia, and is generally well tolerated. However, as with all treatments, adverse effects may occur and awareness may facilitate approaches to prevention and management. Objectives: To review the available evidence relating to the adverse effects of topical PDT, to help inform recommendations in updated clinical guidelines produced by the British Association of Dermatologists and British Photodermatology Group, and the efficacy of preventative and therapeutic approaches. Methods: This review summarizes the published evidence related to the adverse effects of topical PDT and attempts to interpret this evidence in the context of patient risk and management. Results: Pain and discomfort during PDT are acute adverse effects, which can be minimized through the use of modified and low‐irradiance PDT regimens and do not therefore usually limit successful treatment delivery. Other adverse effects include the risk of contact allergy to photosensitizer prodrugs, although this is rare but should be kept in mind, particularly for patients who have received multiple PDT treatments to larger areas. There are no other significant documented longer‐term risks and, to date, no evidence of cumulative toxicity or photocarcinogenic risk. Conclusions: Topical PDT is usually well tolerated, reinforcing the utility of this important therapeutic option in dermatology practice. The main acute adverse effect of pain can typically be minimized through preventative approaches of modified PDT regimens. Other adverse effects are uncommon and generally do not limit treatment delivery. What's already known about this topic? Photodynamic therapy (PDT) is widely used in dermatology.Pain is the most well documented adverse effect.Methods of effective pain relief are limited. What does this study add? This review scrutinizes the literature relating to adverse effects of PDT and management approaches.PDT‐induced pain can usually be effectively prevented and managed through adjustments to PDT regimens, such as using lower irradiance light delivery.Phototoxic reactions are to be expected.Other adverse effects are typically uncommon and not limiting. Linked Editorial:Wulf. Br J Dermatol 2019; 180:695–696. Plain language summary available online [ABSTRACT FROM AUTHOR]

Details several clinical cases of skin diseases. Safe therapies for psoriasis; Treatment of lipomatosis; Cumulative effect of long-term, low-dose isotretinoin on the development of diffuse idiopathic skeletal hyperostosis.

The pulsed tunable dye laser (PTDL) is generally considered lo have a very low incidence of adverse effects, allowing it to become the treatment of choice for the majority of port wine stains (PWS). The low incidence of adverse effects has led to difficulties in determining the true incidence and type of adverse effect seen with this laser. We therefore undertook a retrospective study of 701 patients with PWS, who received 3877 full treatments to determine the incidence and type of adverse effects seen following treatment with the PTDL. Blistering and crusting were seen in 5.9% and 0.7% of patients, respectively, but were transient events which usually healed without permanent sequelae. Hyper-pigmentation was the most frequently observed adverse effect seen in 9.1% of patients but generally showed gradual resolution over 6–12 months. Hypopigmentation was infrequent, seen in 1.4% of patients. The most significant adverse effects were atrophic and hypertrophic scarring seen in 4.3% and 0.7% of patients, respectively. Our observations show that there is a small but definite risk of atrophic scarring with a predisposition for younger patients, Hypertrophic scarring can occur albeit rarely and there may be a predisposition towards the neck. In most cases test areas were not predictive of scarring. This underlines the need for a full discussion of scarring risk in patients with PWS undergoing treatment with the PTDL. [ABSTRACT FROM AUTHOR]

Examines the case of a technician with exposure-pattern dermatitis from exposure to 1,2-benzisothiazolin-3-one (BIT) and dithio-2,2-bis(benzmethylamide). Presence of itchy swelling hands and forearms and facial rash; Treatment with topical corticosteroid on the arms and face; Use of BIT and dithio-2,2-bis(benzmethylamide); Assessment of the sensitization potential of dithio-2,2-bis(benzmethylamide).