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background: Actinic keratosis (AK) is a very common condition, which has the potential of progressing to squamous cell carcinoma. The present study is a prospective, randomized study comparing the lesion response, cosmetic outcome, patient satisfaction and tolerability of a new treatment modality, photodynamic therapy (PDT), using topical methyl aminolevulinate (Metvix®), with the most commonly used standard therapy for AK, cryotherapy.

methods: A total of 204 patients with clinically diagnosed AK were randomized to either cryotherapy or PDT. The PDT patients were further assigned to an active or placebo group in a random, double‐blind manner. Cryotherapy was performed using liquid nitrogen spray in a single freeze–thaw cycle. PDT was performed using 160 mg/g methyl aminolevulinate cream or placebo, a 3‐hour application time, red light (570–670 nm) and a total light dose of 75 J/cm2. PDT was …