Your patient with extensive actinic damage and many of the lesions seen here is interested in field therapy with a light-based modality. On a cellular level, how does photodynamic therapy kill cells that make up this lesion?

A. Heat shock proteins

B. Inhibition of pyrimidine nucleotide synthesis

C. Neutrophil-mediated, antibody-dependent cellular cytotoxicity

D. Reactive singlet oxygen

E. Proteosome inhibition

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