TY - JOUR

T1 - Real-world approach to actinic keratosis management

T2 - practical treatment algorithm for office-based dermatology

AU - Dirschka, Thomas

AU - Gupta, Girish

AU - Micali, Giuseppe

AU - Stockfleth, Eggert

AU - Basset-Séguin, Nicole

AU - Del Marmol, Véronique

AU - Dummer, Reinhard

AU - Jemec, Gregor B E

AU - Malvehy, Josep

AU - Peris, Ketty

AU - Puig, Susana

AU - Stratigos, Alexander J

AU - Zalaudek, Iris

AU - Pellacani, Giovanni

PY - 2017

Y1 - 2017

N2 - Actinic keratosis (AK) is a chronic skin disease in which multiple clinical and subclinical lesions co-exist across large areas of sun-exposed skin, resulting in field cancerisation. Lesions require treatment because of their potential to transform into invasive squamous cell carcinoma. This article aims to provide office-based dermatologists and general practitioners with simple guidance on AK treatment in daily clinical practice to supplement existing evidence-based guidelines. Novel aspects of the proposed treatment algorithm include differentiating patients according to whether they have isolated scattered lesions, lesions clustered in small areas or large affected fields without reference to specific absolute numbers of lesions. Recognising that complete lesion clearance is rarely achieved in real-life practice and that AK is a chronic disease, the suggested treatment goals are to reduce the number of lesions, to achieve long-term disease control and to prevent disease progression to invasive squamous cell carcinoma. In the clinical setting, physicians should select AK treatments based on local availability, and the presentation and needs of their patients. The proposed AK treatment algorithm is easy-to-use and has high practical relevance for real-life, office-based dermatology.

AB - Actinic keratosis (AK) is a chronic skin disease in which multiple clinical and subclinical lesions co-exist across large areas of sun-exposed skin, resulting in field cancerisation. Lesions require treatment because of their potential to transform into invasive squamous cell carcinoma. This article aims to provide office-based dermatologists and general practitioners with simple guidance on AK treatment in daily clinical practice to supplement existing evidence-based guidelines. Novel aspects of the proposed treatment algorithm include differentiating patients according to whether they have isolated scattered lesions, lesions clustered in small areas or large affected fields without reference to specific absolute numbers of lesions. Recognising that complete lesion clearance is rarely achieved in real-life practice and that AK is a chronic disease, the suggested treatment goals are to reduce the number of lesions, to achieve long-term disease control and to prevent disease progression to invasive squamous cell carcinoma. In the clinical setting, physicians should select AK treatments based on local availability, and the presentation and needs of their patients. The proposed AK treatment algorithm is easy-to-use and has high practical relevance for real-life, office-based dermatology.

KW - Algorithms

KW - Aminoquinolines/therapeutic use

KW - Antineoplastic Agents/therapeutic use

KW - Combined Modality Therapy

KW - Cryotherapy

KW - Disease Progression

KW - Humans

KW - Keratosis, Actinic/diagnosis

KW - Laser Therapy

U2 - 10.1080/09546634.2016.1254328

DO - 10.1080/09546634.2016.1254328

M3 - Review

C2 - 27796187

VL - 28

SP - 431

EP - 442

JO - Journal of Dermatological Treatment

JF - Journal of Dermatological Treatment

SN - 0954-6634

IS - 5

ER -