Efficacy and Long-term Recurrence of Lesion-directed and Full-face Photodynamic Therapy for Facial Actinic Keratosis

This study aimed to compare the long-term efficacy and recurrence rates of facial Actinic Keratosis (AK) lesions treated with lesion-directed PDT versus full-face PDT.A total of 261 AK patients were enrolled from five hospitals and divided into two groups: lesion-directed PDT or full-face PDT. The primary outcome was the occurrence of new or recurrent lesions during a 1-year follow-up. Secondary outcomes included the proportion of patients achieving ≥75% reduction in lesion count from baseline at 3 months post-treatment, as well as the occurrence of new or recurrent lesions during a 2–3 year follow-up.At 1 year, the standardized estimated recurrence rates were 11.6% in the lesion-directed group and 5.9% in the full-face group. During the 2–3 year follow-up, the standardized estimated recurrence rates were 13.8% and 15.2% in the lesion-directed group, compared to 7.1% and 9.7% in the full-face group, respectively.Full-face PDT demonstrates lower long-term recurrence rate.