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Actinic keratosis: update on field therapy
Gary Goldenberg1, Marcel Perl2
1Icahn School of Medicine at Mount Sinai, Department of Dermatology, New York, New York;
The Journal of Clinical and Aesthetic Dermatology
|November 6, 2014
Summary
Actinic keratosis is a field disease treated by field-directed therapies. These treatments, including ingenol mebutate and photodynamic therapy, effectively manage subclinical disease, reducing nonmelanoma skin cancer progression.
Area of Science:
- Dermatology
- Oncology
Background:
- Actinic keratosis (AK) is recognized as a field disease, often presenting as more than a single lesion.
- Subclinical disease is presumed to exist alongside clinically apparent AK and squamous cell carcinoma.
Purpose of the Study:
- To evaluate field-directed therapies for actinic keratosis.
- To compare field treatments with lesion-directed cryotherapy and placebo.
- To assess the benefits of combining field and lesion-directed treatments.
Main Methods:
- Review of field-directed therapies such as ingenol mebutate, imiquimod, and photodynamic therapy.
- Comparison of efficacy against placebo and lesion-directed cryotherapy.
- Analysis of long-term follow-up data.
Main Results:
- Field-directed therapies demonstrate efficacy compared to placebo.
- These treatments are effective in managing subclinical actinic keratosis.
- Combination therapy offers potential for optimized efficacy and patient convenience.
Conclusions:
- Field-directed therapies are crucial for treating the field nature of actinic keratosis.
- These treatments can halt the progression of actinic keratosis to squamous cell carcinoma.
- Adoption of field therapies may reduce the incidence and healthcare burden of nonmelanoma skin cancer.
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