Retinoids for prevention and treatment of actinic keratosis

Abstract

Actinic keratosis is a common cause of dermatological consultations and it presents a strong association with squamous cell carcinoma. Many substances are used for treatment and prevention, such as retinoids. Nevertheless, many studies on retinoids emphasize their application in treating and preventing non melanoma skin cancers. In this article, we reviewed studies about systemic and topical retinoids used with immunocompetent patients and organ transplant recipients with actinic keratosis, as primary or secondary outcomes. The majority of these papers pointed to a reduction in actinic keratosis count after treatment with retinoids. However, studies need to be better-defined in order to address the lack of a standardized dose, the absence of control groups, the low number of patients and short follow-up periods. Blind, randomized and controlled clinical trials with adequate sample sizes, specifically focused on actinic keratosis, are needed to clarify the real benefit of topical and/or oral retinoids. Comparison of efficacy and safety between oral and topical retinoids in the prevention and treatment of non-melanoma skin cancers and actinic keratosis is an essential pre requisite to establish new strategies to control these conditions.

Effectiveness and safety of 0·5% colchicine cream vs. photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratosis and skin field cancerization of the forearms: a randomized controlled trial

“…Many treatment modalities for SFC are available, e.g. 5‐fluorouracil, ingenol mebutate, imiquimod, tretinoin, diclofenac and photodynamic therapy (PDT)…”

Neoplastic Multifocal Skin Lesions: Biology, Etiology, and Targeted Therapies for Nonmelanoma Skin Cancers

“…Systemic retinoids can be administrated to treat precancers and cancers, but more often they are used as chemoprevention due to reported side effects [66,67,68,69,70,71]. The most commonly administered systemic retinoids in chemoprevention of skin cancer are: etretinate, acitretin, and isotretinoin [72]. Depending on the dose, the use of retinoids may cause mild (mucocutaneous reactions, hyperostotic axial skeletal changes, mild hair loss, skin xerosis, cheilitis, dry eyes, conjunctivitis, nasal dryness, epistaxis, and irritant dermatitis) to very serious side effects that are unpredictable, rare, dependent on individual susceptibility and predisposing factors (mucocutaneous toxic effects, elevated liver enzymes and liver dysfunction, increased levels of triglycerides and cholesterol, increased LDL fraction and decreased HDL fraction, risk of acute pancreatitis, and hepatotoxicity, skeletal abnormalities, demineralization, calcification of ligaments and vertebral disks, hyperostotic skeletal changes such as enlargement of existing bone spurs, and teratogenic effects) [69,70,71].…”

Keratinocyte Carcinoma (Skin Cancer, Non-Melanoma)☆

“…In widespread lesions, topical 5-fluorouracil (5-FU) available as 0.5%-5% cream and solutions applied for 3-4 weeks will result in significant reduction of a precancerous lesion (Dufresne and Curlin, 1997). Systemic retinoids can be selectively used in severe and extensive cases (Ianhez et al, 2013). In exceptional refractory and extensive cases, medium depth chemical peeling, dermabrasion, and laser resurfacing can be utilized.…”