Photodynamic therapy as a response to the challenge of treating actinic keratosis in the eyelid area.

Around 90% of nonmelanoma skin cancers arise on the head and neck and about 10% of these occur in the area of the eyelids. Surgery continues to be the treatment of choice, but concerns about the risk of postoperative complications, local recurrence, or a poor cosmetic and functional outcome have led to the investigation of alternative options, such as cryotherapy, radiation therapy, chemotherapy, retinoids, topical immunomodulators, and photodynamic therapy (PDT). The choice of treatment will depend on the age of the patient, the site and size of the tumor, and the experience of the dermatologist. We present the case of an 82-year-old man who was seen for a desquamating, partially exophytic erythematous plaque of 1.5 cm in diameter that had developed on the right lower eyelid and affected the free border (Fig. 1A). Biopsy showed the lesion to be an actinic keratosis (Fig. 2A). Photodynamic therapy (PDT) was chosen for treatment in