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Current developments in pharmacotherapy for actinic keratosis.

Elena Campione1, Alessandra Ventura1, Laura Diluvio1

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|September 18, 2018
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Summary

Actinic keratosis (AK) treatments are evolving. Long-term nonsteroidal anti-inflammatory drugs (NSAIDs) and sun filters manage AK, while immunomodulatory therapies offer shorter treatment with careful patient education for better outcomes.

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Area of Science:

  • Dermatology
  • Oncology
  • Photomedicine

Background:

  • Actinic keratosis (AK) is a precursor to squamous cell carcinoma (SCC), driven by chronic sun exposure and DNA damage.
  • UVB radiation, p53 suppression, and increased Bcl-2 expression contribute to AK progression.
  • Inflammation mediated by prostaglandins is crucial for skin tumorigenesis, promoting growth, invasion, and metastasis.

Purpose of the Study:

  • To review recent therapeutic developments for actinic keratosis (AK).
  • To provide expert perspectives on current and future AK treatment strategies.

Main Methods:

  • Review of current literature on AK therapies.
  • Analysis of treatment efficacy and side effect profiles.

Main Results:

  • Long-term piroxicam/sun filters or diclofenac aid AK healing and control field cancerization.
  • NSAIDs are safe for patients using photosensitizing drugs, reducing skin tumor risk.
  • Immunomodulatory therapies show shorter treatment durations but higher local side effects, necessitating patient education.

Conclusions:

  • Both long-term NSAIDs and shorter-term immunomodulatory therapies are valuable for AK management.
  • Patient education is critical for adherence and successful outcomes, especially with immunomodulatory treatments.
  • Future strategies may involve personalized approaches combining different therapeutic modalities.