Xue WL, Ruan JQ, Liu HY, et al. - Bowen’s disease can be treated with photodynamic therapy which affords better efficacy, less recurrence, and better cosmetic outcomes compared with cryotherapy and 5-FU. Improved efficacy can be achieved when photodynamic therapy is coupled with some methods including ablative fractional CO ₂ laser.

• This is a meta-analysis of 8 randomized controlled trials identified from PubMed, EMBASE, Web of Science, and Cochrane Library databases.

• A significantly higher complete response rate (RR = 1.36), less recurrence (RR = 0.53), and better cosmetic outcome (RR = 1.34) were provided by photodynamic therapy vs other treatments.

• Also, significantly less recurrence (RR = 0.21) and a lower visual analogue scale score (RR = 0.51) were achieved when photodynamic therapy was combined with ablative fractional CO ₂ laser or plum-blossom needle, vs photodynamic therapy alone.

• Complete response rate did not significantly differ between photodynamic therapy plus ablative continuous CO ₂ laser and photodynamic therapy plus ablative fractional CO ₂ laser (RR = 1.00).