Pain Management During a Photodynamic Therapy Session on the Vertex for Actinic Keratosis: Tumescent Anesthesia Interest

Inclusion Criteria: * Patients over the age of 18 * Diagnosis of clinical or histological actintic keratoses validated by a dermatologist * More than 4 vertex actinic keratoses lesions that can be treated with a dynamic phototherapy session * Free subject, without guardianship or curatorship or subordination * Person affiliated or beneficiary of a social security plan * Informed and signed consent by the patient after clear and fair information about the study Exclusion Criteria: * Known lidocaine hydrochlostate hypersensitivity, local amide-binding anesthetics or one of the excipients * Hypersensitivity to paracetamol or one of the excipients * Weight \< 50 kg * Patients with an elongated TQ interval at the ECG (\>450 ms in men and \>470 ms in women) * Patients with recurrent porphyria * Severe hepato-cellular insufficient patients * Patients who have received treatment for actinic keratoses in the last three months (cryotherapy, 5-fluorouracil, imiquinod, daylight-PTD) * Patients who have already participated in this study * People who do not have a social security plan or do not benefit from it through a third party. * Persons with enhanced protection, namely minors, persons deprived of their liberty by judicial or administrative decision, persons staying in a health or social institution, adults under legal protection and finally the sick in an emergency situation. * Pregnant or lactating women, women of childbearing age who do not have effective contraception (hormonal/mechanical: per bone, injectable, transcutaneous, implantable, intrauterine device, or surgical: tubal ligation, hysterectomy, total oophorectomy). * Concurrent participation in another clinical research study.