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Lymphomatoid papulosis type D: an aggressive histology for an indolent disease

the section ‘Lesion recurrence rate’ in the Results section). Consequently, this leads to an overestimation of lesion-based recurrence rates in all patient groups [BF-200 ALA (aminolaevulinic acid), MAL (methyl aminolaevulinate) and placebo]. In this respect, as correctly outlined by Professor Kolde, the lesionbased recurrence rates in study ALA-AK-CT003 are more precise than those in study ALA-AK-CT002, which results in unfavourable lesion recurrence rates for both medications – MAL and BF-200 ALA. New actinic keratoses or nonmelanoma skin cancer lesions occurring in the treatment area during follow-up (i.e. within the treatment area but outside the original lesions) were reported independently for both studies and are not mixed up with recurrent lesions (see Table 8 in Dirschka et al.). Even though this difference between the two trials is unfortunate, which was correctly commented on by Professor Kolde, it does not affect the conclusions of the paper; with respect to the numbers of recurrent patients the results are not affected by this protocol inconsistency. With respect to numbers of recurrent lesions, both BF-200 ALA and MAL are affected in the same way, such that there is no influence on the qualitative outcome of the side-by-side comparison. For both drugs, true lesion recurrence rates in the ALA-AK-CT002 study are lower than actually calculated, which may be illustrated by the lower lesion recurrence rate observed for BF-200 ALA in the ALA-AK-CT003 study. With respect to the other drugs mentioned in the Discussion, only recurrent patients are compared, such that the data are not affected.