Italian expert consensus paper on the management of patients with actinic keratoses

Ketty Peris, Maria Concetta Fargnoli, Iris Zalaudek, Elvira Moscarella, Eugenia Veronica Di Brizzi, Alice Casari, Vincenzo De Giorgi, Nicola Di Meo, Francesco Lacarrubba, Giuseppe Micali, Stefano Piaserico, Piergiacomo Calzavara-Pinton, Pietro Quaglino, Cristina Zane, Giuseppe Argenziano

Risultato della ricerca: Contributo in rivistaArticolo in rivista

1 Citazioni (Scopus)

Abstract

Two round tables involving experts were organized in order to reach a consensus on the management of patients with actinic keratosis (AK). In the first, seven clinical questions were selected and analyzed by a systematic literature review, using a Population, Intervention, Control, and Outcomes framework; in the second, the experts discussed relevant evidences and a consensus statement for each question was developed. Consensus was reached among experts on how to best treat AK patients with respect to different clinical scenarios and special populations. Lesion-directed treatments are preferred in patients with few AKs. Patients with multiple AKs are challenging, with more than one treatment usually needed to achieve complete lesion clearance or a high lesion response rate, therapy should be personalized, based on previous treatments, patient, and lesion characteristics. Methyl aminolevulinate-PDT, DL (day light) PDT, and imiquimod cream were demonstrated to have the lowest percentage of new AKs after post treatment follow-up. For IMQ 5% and 3.75%, a higher intensity of skin reactions is associated with higher efficacy. Photodynamic therapy (PDT) is the most studied treatment for AKs on the arms. Regular sunscreen use helps preventing new AKs. Oral nicotinamide 500 mg twice daily, systemic retinoids and regular sunscreen use were demonstrated to reduce the number of new squamous cell carcinomas in patients with AKs. Limited evidence is available for the treatment of AKs in organ transplant recipients. There is no evidence in favor or against the use of any of the available treatments in patients suffering from hematological cancer.
Lingua originaleEnglish
pagine (da-a)e13992-N/A
RivistaDermatologic Therapy
Volume33
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • 0.5% 5-FU (fluoro uracil)-salicylic acid
  • ALA and MAL PDT
  • actinic keratosis
  • cancerization field
  • imiquimod cream (3.75% and 5%)
  • ingenol mebutate gel
  • nicotinamide
  • organ transplant recipients
  • systemic retinoids
  • topical treatment

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