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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Photodynamic therapy &#40;PDT&#41; is a noninvasive treatment that combines a light source with a topical photosensitizing agent&#46; The technique is widely used in dermatology for treating certain oncologic conditions such as actinic keratosis and superficial basal cell carcinoma&#46; While PDT is safe and effective&#44; an appreciable number of patients present local adverse effects such as erythema&#44; pain&#44; and edema at the treatment site&#46; Isolated incidents of other adverse effects have been described&#44; including transitory hyperpigmentation&#44; cellulitis&#44; and&#44; more rarely&#44; milia&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 91-year-old man with skin phototype II on the Fitzpatrick scale and a past history of hypertension and hypertensive heart disease visited our department with lesions in the parieto-occipital region of the scalp&#46; The lesions had appeared 3 years earlier and had not improved despite months of keratolytic therapy&#46; Physical examination revealed multiple soft keratotic crusted papules grouped in the parieto-occipital region of the scalp&#46; Shave biopsy of one of the lesions revealed acanthosis with hyperkeratosis&#44; alternating orthokeratosis and parakeratosis&#44; and focal atypia of keratinocytes in the lower third of the epidermis&#44; confirming the suspected diagnosis of actinic keratosis&#46; PDT was performed using 5-aminolevulinic acid hydrochloride gel &#40;78<span class="elsevierStyleHsp" style=""></span>mg&#47;g&#41;&#46; The area to be treated was covered with an opaque dressing for 3<span class="elsevierStyleHsp" style=""></span>hours&#46; The area was cleaned using saline solution and exposed to a lamp with red light-emitting diodes at a wavelength of 630<span class="elsevierStyleHsp" style=""></span>nm &#40;Aktilite CL128&#44; Galderma&#41; and the dosage recommended in the product information sheet &#40;37<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41;&#46; The patient presented considerable erythema in the treated area at the end of the treatment session&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">By the follow-up visit a month after treatment&#44; the actinic keratosis had completely resolved&#59; however&#44; multiple millimeter-sized monomorphous&#44; whiteish papules were observed in the treated area &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> A&#41;&#46; In light of the suspected diagnosis of milia&#44; a 4-mm punch biopsy was performed&#46; The results of histopathology were compatible with milia&#58; multiple cyst-like structures lined by squamous epithelium with a granular layer and containing orthokeratotic keratin &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Treatment was started with 5&#37; salicylic acid in petroleum jelly&#44; applied once daily&#44; and the lesions improved after 2 months of treatment &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Milia are small epidermal cysts that present as firm whiteish papules with a diameter of less than 3<span class="elsevierStyleHsp" style=""></span>mm&#59; they are thought to originate in the pilosebaceous follicle&#46; Cysts are classed as primary milia when they appear spontaneously&#44; predominantly on the face&#44; and as secondary milia<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> when they are caused by trauma or occur in association with inflammatory skin conditions&#46; Secondary milia have been reported in association with second-degree burns&#44; radiotherapy&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> porphyria cutanea tarda&#44; and after tattooing&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> In our case&#44; the most plausible explanation for the milia may be the intense inflammatory reaction our patient presented during the treatment session&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The appearance of milia following PDT is a rare adverse effect that we had not previously observed in our extensive clinical experience&#46; This phenomenon is known to reflect the severity of phototoxic damage and disruption of the dermal-epidermal junction&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> Milia have been reported in the literature in 3 patients 3 months after PDT &#40;5-aminolevulinic acid hydrochloride&#41;&#46; In 2 of the cases&#44; spontaneous resolution was observed after 6 months<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">In our case&#44; in contrast to the 3 cases mentioned above&#44; onset of milia occurred earlier and the condition resolved more quickly following keratolytic treatment&#46; This difference may be linked to the severity of the inflammatory reaction our patient presented after treatment&#46; As in the cases mentioned above&#44; the milia appeared following the application of topical 5-aminolevulinic acid hydrochloride in actinic keratosis&#46; No similar reactions have been reported to date in cases in which the photosensitizing agent was methyl aminolevulinate&#46; This phenomenon may be explained by the greater affinity of 5-aminolevulinic acid hydrochloride for cancerous tissue&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> which leads to greater collateral damage of healthy tissue&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Paradoxically&#44; PDT is one of the most commonly used treatments for milia en plaque&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">We present a new case of milia following treatment of actinic keratosis using PDT&#46; The patient had no past personal or family history of milia&#46; Given the benign and potentially self-limiting nature of the condition&#44; it is important for dermatologists to be able to identify milia and avoid mistaking it for treatment failure&#46; In our case&#44; although we explained that the condition was benign&#44; the patient stated that he was unhappy with the cosmetic result and we therefore started mild keratolytic treatment with very good results&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; AK&#44; actinic keratosis&#59; PDT&#44; photodynamic therapy&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Phototype&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Photosensitizing Agent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Incubation Time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lamp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dose Regimen&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post-PDT Reaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical Course and Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 1<br>Buinauskaite et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curelight &#40;PhotoCure&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spontaneous remission after 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 2<br>Buinauskaite et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curelight &#40;PhotoCure&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spontaneous remission after 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 3<br>Buinauskaite et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curelight &#40;PhotoCure&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Persistence of milia No treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 4<br>Flores et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 7&#46;8&#37;<br>&#40;Ameluz&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
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Case and Research Letters
Milia: An Uncommon Reaction to Photodynamic Therapy
Milia, una reacción infrecuente tras terapia fotodinámica
V. Flores-Climente
Autor para correspondencia
vflores@santpau.cat

Corresponding author.
, J. Dalmau, L. Puig
Servicio de Dermatología, Hospital de la Sant Creu i Sant Pau, Barcelona, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Photodynamic therapy &#40;PDT&#41; is a noninvasive treatment that combines a light source with a topical photosensitizing agent&#46; The technique is widely used in dermatology for treating certain oncologic conditions such as actinic keratosis and superficial basal cell carcinoma&#46; While PDT is safe and effective&#44; an appreciable number of patients present local adverse effects such as erythema&#44; pain&#44; and edema at the treatment site&#46; Isolated incidents of other adverse effects have been described&#44; including transitory hyperpigmentation&#44; cellulitis&#44; and&#44; more rarely&#44; milia&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 91-year-old man with skin phototype II on the Fitzpatrick scale and a past history of hypertension and hypertensive heart disease visited our department with lesions in the parieto-occipital region of the scalp&#46; The lesions had appeared 3 years earlier and had not improved despite months of keratolytic therapy&#46; Physical examination revealed multiple soft keratotic crusted papules grouped in the parieto-occipital region of the scalp&#46; Shave biopsy of one of the lesions revealed acanthosis with hyperkeratosis&#44; alternating orthokeratosis and parakeratosis&#44; and focal atypia of keratinocytes in the lower third of the epidermis&#44; confirming the suspected diagnosis of actinic keratosis&#46; PDT was performed using 5-aminolevulinic acid hydrochloride gel &#40;78<span class="elsevierStyleHsp" style=""></span>mg&#47;g&#41;&#46; The area to be treated was covered with an opaque dressing for 3<span class="elsevierStyleHsp" style=""></span>hours&#46; The area was cleaned using saline solution and exposed to a lamp with red light-emitting diodes at a wavelength of 630<span class="elsevierStyleHsp" style=""></span>nm &#40;Aktilite CL128&#44; Galderma&#41; and the dosage recommended in the product information sheet &#40;37<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41;&#46; The patient presented considerable erythema in the treated area at the end of the treatment session&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">By the follow-up visit a month after treatment&#44; the actinic keratosis had completely resolved&#59; however&#44; multiple millimeter-sized monomorphous&#44; whiteish papules were observed in the treated area &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> A&#41;&#46; In light of the suspected diagnosis of milia&#44; a 4-mm punch biopsy was performed&#46; The results of histopathology were compatible with milia&#58; multiple cyst-like structures lined by squamous epithelium with a granular layer and containing orthokeratotic keratin &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Treatment was started with 5&#37; salicylic acid in petroleum jelly&#44; applied once daily&#44; and the lesions improved after 2 months of treatment &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Milia are small epidermal cysts that present as firm whiteish papules with a diameter of less than 3<span class="elsevierStyleHsp" style=""></span>mm&#59; they are thought to originate in the pilosebaceous follicle&#46; Cysts are classed as primary milia when they appear spontaneously&#44; predominantly on the face&#44; and as secondary milia<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> when they are caused by trauma or occur in association with inflammatory skin conditions&#46; Secondary milia have been reported in association with second-degree burns&#44; radiotherapy&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> porphyria cutanea tarda&#44; and after tattooing&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> In our case&#44; the most plausible explanation for the milia may be the intense inflammatory reaction our patient presented during the treatment session&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The appearance of milia following PDT is a rare adverse effect that we had not previously observed in our extensive clinical experience&#46; This phenomenon is known to reflect the severity of phototoxic damage and disruption of the dermal-epidermal junction&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> Milia have been reported in the literature in 3 patients 3 months after PDT &#40;5-aminolevulinic acid hydrochloride&#41;&#46; In 2 of the cases&#44; spontaneous resolution was observed after 6 months<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">In our case&#44; in contrast to the 3 cases mentioned above&#44; onset of milia occurred earlier and the condition resolved more quickly following keratolytic treatment&#46; This difference may be linked to the severity of the inflammatory reaction our patient presented after treatment&#46; As in the cases mentioned above&#44; the milia appeared following the application of topical 5-aminolevulinic acid hydrochloride in actinic keratosis&#46; No similar reactions have been reported to date in cases in which the photosensitizing agent was methyl aminolevulinate&#46; This phenomenon may be explained by the greater affinity of 5-aminolevulinic acid hydrochloride for cancerous tissue&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> which leads to greater collateral damage of healthy tissue&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Paradoxically&#44; PDT is one of the most commonly used treatments for milia en plaque&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">We present a new case of milia following treatment of actinic keratosis using PDT&#46; The patient had no past personal or family history of milia&#46; Given the benign and potentially self-limiting nature of the condition&#44; it is important for dermatologists to be able to identify milia and avoid mistaking it for treatment failure&#46; In our case&#44; although we explained that the condition was benign&#44; the patient stated that he was unhappy with the cosmetic result and we therefore started mild keratolytic treatment with very good results&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Phototype&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Photosensitizing Agent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Incubation Time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lamp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dose Regimen&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Post-PDT Reaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical Course and Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 1<br>Buinauskaite et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curelight &#40;PhotoCure&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spontaneous remission after 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 2<br>Buinauskaite et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curelight &#40;PhotoCure&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spontaneous remission after 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 3<br>Buinauskaite et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Curelight &#40;PhotoCure&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Persistence of milia No treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient 4<br>Flores et al&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AK grade I-II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Parieto-occipital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5-aminolevulinic acid hydrochloride&#44; 7&#46;8&#37;<br>&#40;Ameluz&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Aktilite CL128 &#40;Galderma&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 J&#47;cm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Erythema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Improvement with 5&#37; salicylic acid after 2 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cases of Milia Following Photodynamic Therapy Published in the Literature&#46;</p>"
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