The importance of early diagnosis and treatment of actinic keratosis

Rigel, Darrell S.; Gold, Linda F Stein

doi:10.1016/j.jaad.2012.10.001

Cited by 75 publications

(58 citation statements)

References 62 publications

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“…Here, we review the clinical data on BF-200 ALA for AK along with a summary of molecular mechanisms and future perspectives. Actinic keratosis (AK), also known as solar keratosis, is caused by chronic exposure to sunlight or other ultraviolet light sources [1,2] and may progress to invasive squamous cell carcinoma (SCC) [3]. It is the most common lesion with malignant potential to arise on the skin.…”

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confidence: 99%

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Reinhold¹

2017

Future Oncol.

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BF-200 ALA is a combination of a nanoscale-lipid vesicle formulation and the prodrug 5-aminolevulinic acid (5-ALA). The nanoemulsion stabilizes the prodrug and enhances its penetration through the stratum corneum. It has shown excellent therapeutic results in both lesion and field-directed photodynamic therapy of actinic keratosis (AK). AK is an early form of epidermal neoplasia and a precursor of invasive cutaneous squamous cell carcinoma. It is characterized by the combination of visible neoplastic lesions and surrounding tissue also harboring tumorigenic UV-induced mutations: a concept called field cancerization. A selective, field-directed treatment is ideal to meet the requirements of field change. Here, we review the clinical data on BF-200 ALA for AK along with a summary of molecular mechanisms and future perspectives. Actinic keratosis (AK), also known as solar keratosis, is caused by chronic exposure to sunlight or other ultraviolet light sources [1,2] and may progress to invasive squamous cell carcinoma (SCC) [3]. It is the most common lesion with malignant potential to arise on the skin. AK is mostly seen in Caucasians in skin areas that have extensive sun exposure throughout their lives [4]. Epidemiological data show a high occurrence rate of AK. Regions with higher ultraviolet exposure have a higher prevalence of AK. For the USA, the prevalence was estimated to range from 11 to 26%, while in Australia it ranged from 40 to 60%. In Europe, a prevalence of 15% in men and 6% in women has been documented [5]. Over the age of 70 years, 34% of men and 18% of women were found to have actinic keratotic lesions [6]. Next to fair skin type, an advanced age and lifelong sun exposure immunosuppression/-deficiency plays another important risk factor [5].Mostly, AK develops slowly and early in the disease process, they may disappear only to reappear later. Recurrence of the disease may include partial elimination of the initial lesion, subclinical lesion progression to visible status, or development of new lesions [7]. On top of this, an AK may progress to invasive SCC, the second-most common form of skin cancer [8,9]. The actual percentage of progress to invasive SCC remains unknown, and estimates vary from 5 to 20% within 10 to 25 years with reported annual transformation rates varying greatly from as low as 0.25% to as high as 16% [10]. The regression rate for a single untreated lesion is 15 to 63% after a year; recurrence rates range from 15 to 53% [11]. In general patients develop multiple AKs in one area and predicting which course each individual lesion will follow is impossible. Nonetheless, AK lesions are reliable markers for patients who are most predisposed to developing invasive SCC [4,[12][13].AK lesions typically appear in areas most frequently exposed to the sun such as the face, back of the hands, or bald scalp; 75% of lesions are found on the head, neck and forearms [14]. The lesions vary in appearance as well as size and can include erythematous scaly macules, rough pigmented patches and hyperker...

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confidence: 99%

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Reinhold¹

2017

Future Oncol.

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“…A number of studies showed the efficacy of this treatment modality for field cancerization, since it provides the treatment of subclinical lesions [82][83][84] .…”

Section: Premalignant Lesions Of Skinmentioning

confidence: 99%

Clinical Photodynamic Therapy Review and the Brazilian Experience

et al. 2016

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Photodynamic therapy (PDT) is a simple and promising technique indicated for the treatment of non-melanoma skin cancer. Although multicenter research trials have proved its success, PDT is not as much disseminated as surgery andcryotherapy approaches are. A light-activated substance (a photosensitizer) is usually topically administered. By irradiating the sensitized region with specific wavelengths and appropriated light dose, reactive oxygen species take place, which oxidize molecules and destroy tumor cells. This review article presents not only the base principles of PDT, but also a unique experience Brazil-wide, which reached other countries in Latin America. This initiative was funded by the Brazilian government via the Brazilian Development Bank (BNDES), involving private companies and academia in a validation study of the treatment of both pre-malignant and malignant skin cancer lesions.PDT protocol evolution is presented, including details that made the technique highly efficient and placed this experiencein a larger context.

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“…The development of SCC in sun damaged skin is a gradual process and the majority of invasive SCC's result from actinic keratosis. [5] As such some studies have recommended an alternative classification system for actinic keratosis. Early in situ SCC has been recommended for type AK1, early in situ SCC for type AK2 and in situ SCC for type AK3.…”

Section: Introductionmentioning

confidence: 99%

“…[9] Furthermore, studies have shown that, ultraviolet radiation induced mutations and changes in gene expression are present in SCC, actinic keratosis and sun exposed skin. [5] Actinic keratosis, is usually the first lesion in a disease continuum that progresses to invasive SCC. The risk of progression from actinic keratosis to SCC depends on a number of patient factors.…”

Section: Introductionmentioning

confidence: 99%

Actinic Keratosis and Squamous Cell Carcinoma

Lalji¹

2014

CRDOA

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The importance of early diagnosis and treatment of actinic keratosis

Cited by 75 publications

References 62 publications

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Clinical Photodynamic Therapy Review and the Brazilian Experience

Actinic Keratosis and Squamous Cell Carcinoma

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