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Structured Expert Consensus on Actinic Keratosis: Treatment Algorithm Focusing on Daylight PDT
Piergiacomo Calzavara-Pinton1, Merete Hædersdal2, Kirk Barber3
1Department of Dermatology, University of Brescia, Brescia, Italy.
Journal of Cutaneous Medicine and Surgery
|April 14, 2017
Summary
Expert consensus provides practical actinic keratosis (AK) management guidelines. Daylight photodynamic therapy (dl-PDT) is recommended for multiple AK lesions, improving patient care.
Area of Science:
- Dermatology
- Oncology
Background:
- Actinic keratosis (AK) management requires updated expert consensus for improved patient care.
- Current guidelines may lack detail on emerging AK treatments.
Purpose of the Study:
- To establish a structured consensus statement on actinic keratosis diagnosis, classification, and management.
- To integrate new treatment information, including daylight photodynamic therapy (dl-PDT).
Main Methods:
- Systematic review of existing actinic keratosis clinical guidelines.
- Three-round Delphi procedure with 16 international clinical experts.
- Consensus meeting to develop a treatment algorithm and statement.
Main Results:
- Deficiencies identified in guidelines regarding ingenol mebutate and dl-PDT.
- Consensus reached on AK definition, diagnosis, classification, and management principles.
- Treatment decisions incorporate patient factors and environmental attributes; ranked preferences established.
- AK classified into three clinical situations (isolated, small field, large field) with tailored treatment approaches.
Conclusions:
- Practical, clinically transferable recommendations for actinic keratosis treatment developed.
- Physician clinical judgment is integrated into the consensus.
- Daylight photodynamic therapy (dl-PDT) is positioned as a valuable option for multiple AK lesions.
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