Structured Expert Consensus on Actinic Keratosis: Treatment Algorithm Focusing on Daylight PDT

Ketty Peris, Piergiacomo Calzavara Pinton, Piergiacomo Calzavara-Pinton, Merete Hædersdal, Kirk Barber, Nicole Basset-Seguin, María Emilia Del Pino Flores, Peter Foley, Gaston Galimberti, Rianne Gerritsen, Yolanda Gilaberte, Sally Ibbotson, Sheetal Sapra, Elena Sotiriou, Luis Torezan, Claas Ulrich, Jonathan Guillemot, Janek Hendrich, Rolf-Markus Szeimies

Risultato della ricerca: Contributo in rivistaArticolo in rivista

25 Citazioni (Scopus)

Abstract

BACKGROUND: A practical and up-to-date consensus among experts is paramount to further improve patient care in actinic keratosis (AK). OBJECTIVES: To develop a structured consensus statement on the diagnosis, classification, and practical management of AK based on up-to-date information. METHODS: A systematic review of AK clinical guidelines was conducted. This informed the preparation of a 3-round Delphi procedure followed by a consensus meeting, which combined the opinions of 16 clinical experts from 13 countries, to construct a structured consensus statement and a treatment algorithm positioning daylight photodynamic therapy (dl-PDT) among other AK treatment options. RESULTS: The systematic review found deficiencies in current guidelines with respect to new AK treatments such as ingenol mebutate and dl-PDT. The Delphi panel established consensus statements across definition, diagnosis, classification, and management of AK. While the diagnosis of AK essentially rests on the nature of lesions, treatment decisions are based on several clinical and nonclinical patient factors and diverse environmental attributes. Participants agreed on ranked treatment preferences for the management of AK and on classifying AK in 3 clinical situations: isolated AK lesions requiring lesion-directed treatment, multiple lesions within a small field, and multiple lesions within a large field, both requiring specific treatment approaches. Different AK treatment options were discussed for each clinical situation. CONCLUSIONS: The results provide practical recommendations for the treatment of AK, which are readily transferable to clinical practice, and incorporate the physician's clinical judgement. The structured consensus statement positioned dl-PDT as a valuable option for patients with multiple AKs in small or large fields.
Lingua originaleEnglish
pagine (da-a)1203475417702994-16S
RivistaJournal of Cutaneous Medicine and Surgery
Volume21
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Delphi methodology
  • actinic keratosis
  • consensus
  • treatment algorithm

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