Contemporary management of actinic keratosis

Navarrete‐Dechent, Cristián; Marghoob, Ashfaq A.; Marchetti, Michael A.

doi:10.1080/09546634.2019.1682504

Cited by 7 publications

(11 citation statements)

References 22 publications

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“…Clinically, the majority of patients with AK will evolve into CSCC. 7 The RNA was extracted by laser capture microdissection from 10 Actinic keratosis and 30 CSCC, for analysis using the Affymetrix HG U133 Plus 2.0 microarrays. The transcriptomic data were calculated using GEO2R online (https://www.ncbi.nlm.nih.gov/geo/geo2r/).…”

Section: Cutaneous Squamous Cell Carcinoma (Cscc) (Nmentioning

confidence: 99%

The value of ACTN1 in the diagnosis of cutaneous squamous cell carcinoma: A continuation study

Yuan

Xiao‐hong

et al. 2023

Skin Research and Technology

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Section: Cutaneous Squamous Cell Carcinoma (Cscc) (Nmentioning

confidence: 99%

The value of ACTN1 in the diagnosis of cutaneous squamous cell carcinoma: A continuation study

Yuan

Xiao‐hong

et al. 2023

Skin Research and Technology

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“…They typically present as multiple lesions in the form of scaly patches, macules or papules with poorly defined borders, and occasionally appear as thick, adherent scales over an erythematous base [ 3 , 4 ]. AKs can persist in the same stage or may regress spontaneously (15–63% of lesions per year) or undergo malignant transformation into invasive squamous cell carcinoma (iSCC; 0.1–20% of lesions or up to 0.5% of lesions per year) [ 1 , 5 ]. The prevalence of AK is 11–25% worldwide [ 6 ], and depends on the geographical variability in ultraviolet radiation levels [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…In patients with AK, the primary treatment goals are the eradication (complete or partial) of lesions, improvement in skin appearance, reduction in pain and other symptoms, increase in disease-free intervals and decrease in the overall risk of malignant progression to iSCC [ 1 , 5 ]. The choice of treatment is based on the location of the lesions and treatment-related factors, as well as patient characteristics and preferences [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Severity of Local Skin Reactions with 4% 5-Fluorouracil Plus Emollient versus 4% 5-Fluorouracil Alone in Patients with Actinic Keratosis: A Single-Blind Randomised Trial

Stockfleth

Jouary

Farnetani

et al. 2023

Dermatol Ther (Heidelb)

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Introduction: Topical 5-fluorouracil (5-FU)containing treatments are effective for actinic keratosis (AK); however, they frequently lead to transient local skin reactions (LSRs), which often result in treatment non-adherence. Methods: The aim of this international, phase IV clinical trial was to investigate whether addition of an emollient to topical 4% 5-FU would reduce the frequency and severity of LSRs over 4 weeks of treatment (intervention group) compared with 4% 5-FU alone (control group) in patients with AK. The primary objective was to assess the severity of LSRs (i.e. erythema, flaking/scaling, crusting, swelling, vesiculation/pustulation and erosion/ulceration) at week 4 of treatment (or before, in case of a major local reaction). Key secondary objectives were LSR total scores at weeks 2 and 8, the scores of individual LSR items at each visit, and the proportions of patients with 100% and C 75% AK lesion clearance at week 8. Results: In total, 141 patients were included in the efficacy analysis (71 in the intervention group and 70 in the control group). There were no statistically or clinically significant differences between the treatment groups in terms of LSR total score at week 4 (overall and by subgroups defined by the number of lesions and patient age at baseline), scores of individual LSR items at any time point, and AK lesion clearance rates at week 8. LSR scores with topical 4% 5-FU alone were lower than expected. Skin reactions

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“…Other therapies with less efficacy include ingenol mebutate, topical diclofenac gel, and piroxicam. The choice of therapy should be based on multiple factors, such as efficacy, tolerability, patient risk profile, costs, and cosmetic results [5,8,9] (Fig. 2).…”

Section: Introductionmentioning

confidence: 99%

Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization

Piquero-Casals¹,

Morgado‐Carrasco

Gilaberte

et al. 2020

Dermatol Ther (Heidelb)

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Field cancerization (FC) is a chronic disease involving multiple clinical and subclinical actinic keratoses (AK) on large photo-exposed surfaces with multifocal areas of dysplasia and precancerous changes. Patients and treatment must be properly monitored and managed to avoid aggravation and progression of the disease. Management of actinic keratoses includes lesion-directed treatments, such as cryotherapy and field-directed therapies. Field-directed therapies may have the potential to address subclinical damage, reduce AK recurrence rates and potentially reduce the risk of squamous cell carcinoma development. Multiple studies have demonstrated the efficacy of field-directed treatments, including 5-fluorouracil, photodynamic therapy, imiquimod, chemical exfoliation with trichloroacetic acid and diclofenac gel, for multiple AK and FC. The choice of therapy should be based on multiple factors, such as efficacy, tolerability, patient risk profile, costs and cosmetic results. Management of AK includes not only treatment but also prevention. Medical devices, such as sunscreens containing liposome-encapsulated DNA repair enzymes, can repair DNA damage associated with chronic UV radiation and reduce the number of new AK lesions. Here we provide therapeutic pearls and expert opinions on the treatment of AK and FC (as monotherapy or in combination) with the overall aim to achieve better, faster, and well-tolerated clinical responses.

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Contemporary management of actinic keratosis

Cited by 7 publications

References 22 publications

The value of ACTN1 in the diagnosis of cutaneous squamous cell carcinoma: A continuation study

The value of ACTN1 in the diagnosis of cutaneous squamous cell carcinoma: A continuation study

Severity of Local Skin Reactions with 4% 5-Fluorouracil Plus Emollient versus 4% 5-Fluorouracil Alone in Patients with Actinic Keratosis: A Single-Blind Randomised Trial

Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization

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