Field treatment of actinic keratoses - focus on COX-2-inhibitors

Actinic keratoses (AK) represent the most common carcinoma in situ of the skin and show continuously increasing incidences worldwide. Clinically, AK occur as multiple lesions in sun-exposed areas, which has been referred to as field cancerization. Novel treatment modalities for actinic field cancerization include 3 % diclofenac in 2.5 % hyaluronic acid (HA). Recent investigations have gained insights in the mode of action of diclofenac in HA, showing that the induction of apoptosis is the major mode of action of this treatment. Herein, we give an overview about actinic keratosis focusing on treatment with the COX-2 inhibitor diclofenac 3 % gel and summarize current concepts of its antineoplastic mode of action.