Morphologic grading and treatment of facial actinic keratosis

Zalaudek, Iris; Piana, Simonetta; Moscarella, Elvira; Longo, Caterina; Zendri, Enrico; Castagnetti, Fabio; Pellacani, Giovanni; Lallas, Aimilios; Argenziano, Giuseppe

doi:10.1016/j.clindermatol.2013.05.028

Cited by 75 publications

(88 citation statements)

References 33 publications

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“…The diagnosis of AK was performed both clinically and dermoscopically, respectively based on the presence of erythematous macular lesions with or without a slightly scaly surface, and on the identification of the typical red pseudonetwork, corresponding to grade I AK, or strawberry pattern, corresponding to grade II AK[12]. …”

Section: Methodsmentioning

confidence: 99%

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Skroza

Proietti

Bernardini

et al. 2017

WJCO

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AIMTo determine factors independently influencing response to ingenol mebutate therapy and assess efficacy on clinical setting of non-hypertrophic non-hyperkeratotic actinic keratosis (AK).METHODSConsecutive patients affected by non-hypertrophic non-hyperkeratotic AKs of the face or scalp were enrolled to receive ingenol mebutate 0.015% gel on a selected skin area of 25 cm2 for 3 consecutive days. Local skin reactions were calculated at each follow up visit using a validated composite score. Efficacy was evaluated by the comparison of clinical and dermoscopic pictures before the treatment and at day 57, and classified as complete, partial and poor response.RESULTSA number of 130 patients were enrolled, of which 101 (77.7%) were treated on the face, while 29 (22.3%) on the scalp. The great majority of our study population (n = 119, 91.5%) reached at least a 75% clearance of AKs and, in particular, 58 patients (44.6%) achieved a complete response while 61 (46.9%) a partial one. Logistic backward multivariate analysis showed that facial localization, level of local skin reaction (LSR) at day 2, the highest LSR values and level of crusts at day 8 were factors independently associated with the achievement of a complete response.CONCLUSIONIngenol mebutate 0.015% gel, when properly applied, is more effective on the face than on the scalp and efficacy is directly associated to LSR score.

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Section: Methodsmentioning

confidence: 99%

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Skroza

Proietti

Bernardini

et al. 2017

WJCO

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“…A review of each patient’s medical record, including age, sex, clinical stage,9 pathologic report, and mode of IM treatment, number of AKs before and after treatment, LSRs, and the degree of pain was performed. Photographs were taken before the initial treatment and on every visit during follow-up periods.…”

Section: Methodsmentioning

confidence: 99%

Ingenol mebutate in low amounts for the treatment of actinic keratosis in Korean patients

Joe¹,

Oh²

2017

CCID

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BackgroundIngenol mebutate (IM), a novel agent for field therapy of actinic keratosis (AK), has a drawback of inducing local skin reactions (LSRs), which may cause discomfort in patients. To reduce the LSRs, we tried the application of IM in low amounts.ObjectiveThe purpose of this study was to review Korean patients with AK being treated with IM and evaluate the LSRs and therapeutic outcomes of low amounts of IM.MethodsWe retrospectively reviewed 47 patients with AK on the face. A total of 20 and 27 patients were treated by applying recommended amount of 18.8 mg/cm2 and the lower amount of 10 mg/cm2, respectively.ResultsThe mean composite LSR score for the low amount group (LAG; 12.18±3.29) was significantly lower than that for the recommended amount group (RAG; 15.45±2.70) (P<0.01, independent sample t-test). The 2-month clearance rate calculated by the number of AKs before and after treatment in each patient was significantly higher for RAG (88.16%), compared with 75.56% for LAG (P<0.001).ConclusionLow amount of IM for the treatment of facial AK significantly reduced LSRs in Korean patients. Minimizing LSRs may allow for a secondary targeting treatment of IM for the residual lesions, depending on initial treatment outcomes.

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“…Occurrence of distant metastases is rare and does not exceed the 5% of cases of primary lesions which undergo excision [7]. SCC occurs frequently in the so-called cancerization field mainly characterized by dysplasia of keratinocytes [11]. Obviously, rising up from a plain dysplastic field, these cancers can often present positive margins, which may cause an incorrect assessment of the clinical macroscopic margins or an incorrect interpretation of dysplasia itself.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Squamocellular Carcinoma of the Skin: Clinicopathological Features Predicting the Involvement of the Surgical Margins and Review of the Literature

et al. 2016

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Background: The new AJCC classification has highlighted some particular risk factors for squamous cell carcinoma (SCC) relevant for prognosis. Incomplete excision is not infrequent in SCC. The aim of this study is to examine features that can predict an incomplete excision on the basis of the new AJCC classification and to review the literature on this topic. Materials and Methods: 81 SCC patients were included. All patients were submitted to excisional biopsy with a margin of at least 4 mm from the clinical edges as recommended. Histological characteristics of the lesions analysed were maximum diameter, grading, site, Breslow thickness, Clark level, deep tissue invasion (neural, bone, muscle), presence of ulceration and positivity of the margins. Results: The average Breslow thickness was 3.93 mm. Out of the 81 patients included, 14 showed involved margins. The 2 parameters that were implicated in predicting involvement of the margins in the multivariable model were Breslow thickness and location of the lesion on the ear or lip. Grading was not associated with involvement of margins. Conclusion: According to the new AJCC classification, this study could be useful to plan the most suitable surgical technique in order to avoid the risk of incomplete surgery.

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Morphologic grading and treatment of facial actinic keratosis

Cited by 75 publications

References 33 publications

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

Ingenol mebutate in low amounts for the treatment of actinic keratosis in Korean patients

Squamocellular Carcinoma of the Skin: Clinicopathological Features Predicting the Involvement of the Surgical Margins and Review of the Literature

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