Real-world approach to actinic keratosis management: practical treatment algorithm for office-based dermatology

Thomas Dirschka, Girish Gupta, Giuseppe Micali, Eggert Stockfleth, Nicole Basset-Séguin, Véronique Del Marmol, Reinhard Dummer, Gregor B. E. Jemec, Josep Malvehy, Ketty Peris, Susana Puig, Alexander J. Stratigos, Iris Zalaudek, Giovanni Pellacani

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalTHE JOURNAL OF DERMATOLOGICAL TREATMENT
DOIs
Publication statusPublished - 2016

Keywords

  • 2708
  • 5-fluorouracil
  • Diclofenac
  • field cancerisation
  • imiquimod
  • ingenol mebutate
  • photodynamic therapy

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