Current and emerging treatment strategies for the treatment of actinic keratosis

Berlin, Joshua M.

doi:10.2147/ccid.s9910

Cited by 16 publications

(21 citation statements)

References 43 publications

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“…AK has a prevalence of 6%–60%, depending on age, gender, predisposing risk factors and geographical location . This prevalence appears to be increasing .…”

Section: Introductionmentioning

confidence: 99%

“…3 Several studies have shown a risk of progression of individual AK lesions to SCC of 0.025%-16% per year. 4 Studies have also demonstrated that AKs are often contiguous with an SCC, [5][6][7] in as many as 97% of cases. 8 Furthermore, mutations in the tumor suppressor gene p53 are common to both AK and iSCC, 9 and similar differentially expressed genes in AK and SCC indicate a close genetic relationship.…”

Section: Introductionmentioning

confidence: 99%

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The importance of treating the field in actinic keratosis

Stockfleth

2017

Acad Dermatol Venereol

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Actinic keratoses (AKs) are intraepithelial atypical proliferations of keratinocytes that develop in skin that has undergone long-term exposure to ultraviolet radiation. Given the ageing population and an increasing prevalence of AK, the socioeconomic burden of AK is likely to rise over the coming years. Areas of subclinical (non-visible) sun damage in the periphery of visible AK lesions contain the same genetic changes as those found in the lesions themselves, and are known as areas of field cancerization. AK lesions and the field are associated with an increased risk of skin cancer, including invasive squamous cell carcinoma. Although effective in clearing visible AK, lesion-directed therapies do not address field cancerization and can lead to high recurrence rates. In contrast, field-directed therapies, such as ingenol mebutate, imiquimod and diclofenac, can clear both visible and subclinical AK lesions and reduce the development of new lesions in the treated field. Additionally, preclinical studies suggest that field therapy may prevent or delay the recurrence of non-melanoma skin cancer. AK treatment guidelines now recognize the importance of treating the field in patients with AK, and adaptation of treatment guidelines into clinical practice is warranted. Physician and patient education around the consequences of leaving the field of cancerization untreated is necessary in order to reduce the increasing burden associated with AK.

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“…AK has a prevalence of 6%–60%, depending on age, gender, predisposing risk factors and geographical location . This prevalence appears to be increasing .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The importance of treating the field in actinic keratosis

Stockfleth

2017

Acad Dermatol Venereol

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“…Imiquimod 5% cream was initially approved by the U.S. Food and Drug Administration in 1997 for the treatment of external genital and perianal human papillomavirus infection (Berlin, 2010). It subsequently gained approval for the treatment of nonhyperkeratotic, nonhypertrophic actinic keratoses in 2004.…”

Section: Imiquimodmentioning

confidence: 99%

Actinic Keratosis

Berlin¹

2014

Journal of the Dermatology Nurses’ Association

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Actinic keratoses are some of the most widely encountered lesions in dermatology practices. They represent the second most common reason for patients to visit a dermatologist. There are many different approaches available to treat actinic keratoses, and the dermatology nurse plays a pivotal part in educating patients about their choices. The purpose of this article is to review how these different treatments work and to address potential advantages and disadvantages of each.

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“…AK presents as lesions, which vary in form from flat, reddened or pink macules to rough, scaly patches or plaques, commonly on the face, scalp, dorsal hands and forearms (2). Lesions can occur in isolation but more often multiple lesions occur within an area associated with underlying actinic damage (3).…”

Section: Introductionmentioning

confidence: 99%

“…Patients treated with topical AK therapies commonly experience local skin responses (LSRs), such as erythema, crusting and flaking (2). However, systemic responses can also occur, most notably alongside treatment with imiquimod (3.75% and 5%), which can cause flu-like symptoms (17,19).…”

Section: Introductionmentioning

confidence: 99%