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Quantifying actinic keratosis: assessing the evidence.
1Department of Dermatology, School of Medicine, University of California, San Francisco, California 94401, USA. ernstepstein@hotmail.com
American Journal of Clinical Dermatology
|June 10, 2004
Summary
Counting actinic keratoses is unreliable for evaluating treatment efficacy. This flawed method lacks reproducibility, hindering accurate assessment of therapies for these pre-malignant lesions. A reliable quantification technique is essential.
Area of Science:
- Dermatology
- Oncology
- Medical Statistics
Background:
- Actinic keratoses (AKs) are pre-malignant skin lesions requiring destruction.
- Effective management necessitates reliable data on treatment efficacy.
- Current methods for evaluating AKs often rely on lesion counts.
Purpose of the Study:
- To highlight the inadequacy of counting as a method for quantifying actinic keratoses.
- To emphasize the need for a reliable technique to assess treatment efficacy and natural history.
Main Methods:
- Review of existing literature on actinic keratosis quantification.
- Analysis of the limitations of lesion counting in clinical studies.
Main Results:
- Counting actinic keratoses lacks interobserver reproducibility.
- This unreliability renders studies based on counting fatally flawed.
- Conclusions drawn from counting-based studies are of doubtful accuracy.
Conclusions:
- Counting actinic keratoses should be abandoned for evaluating treatment efficacy and spontaneous regression.
- A reliable method for quantifying actinic keratoses is critically needed for accurate research and clinical practice.