Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization
Abstract Field cancerization (FC) is a chronic disease involving multiple clinical and subclinical actinic keratoses (AK) on large photo-exposed surfaces with multifocal areas of dysplasia and precancerous changes. Patients and treatment must be properly monitored and managed to avoid aggravation an...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2020-07-01
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| Series: | Dermatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s13555-020-00425-4 |
| _version_ | 1818742973076078592 |
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| author | Jaime Piquero-Casals Daniel Morgado-Carrasco Yolanda Gilaberte Rubén Del Rio Antonio Macaya-Pascual Corinne Granger José Luis López-Estebaranz |
| author_facet | Jaime Piquero-Casals Daniel Morgado-Carrasco Yolanda Gilaberte Rubén Del Rio Antonio Macaya-Pascual Corinne Granger José Luis López-Estebaranz |
| author_sort | Jaime Piquero-Casals |
| collection | DOAJ |
| description | Abstract Field cancerization (FC) is a chronic disease involving multiple clinical and subclinical actinic keratoses (AK) on large photo-exposed surfaces with multifocal areas of dysplasia and precancerous changes. Patients and treatment must be properly monitored and managed to avoid aggravation and progression of the disease. Management of actinic keratoses includes lesion-directed treatments, such as cryotherapy and field-directed therapies. Field-directed therapies may have the potential to address subclinical damage, reduce AK recurrence rates and potentially reduce the risk of squamous cell carcinoma development. Multiple studies have demonstrated the efficacy of field-directed treatments, including 5-fluorouracil, photodynamic therapy, imiquimod, chemical exfoliation with trichloroacetic acid and diclofenac gel, for multiple AK and FC. The choice of therapy should be based on multiple factors, such as efficacy, tolerability, patient risk profile, costs and cosmetic results. Management of AK includes not only treatment but also prevention. Medical devices, such as sunscreens containing liposome-encapsulated DNA repair enzymes, can repair DNA damage associated with chronic UV radiation and reduce the number of new AK lesions. Here we provide therapeutic pearls and expert opinions on the treatment of AK and FC (as monotherapy or in combination) with the overall aim to achieve better, faster, and well-tolerated clinical responses. |
| first_indexed | 2024-12-18T02:21:01Z |
| format | Article |
| id | doaj.art-2f83c6b9de364f3cb98f98f30b394cb5 |
| institution | Directory Open Access Journal |
| issn | 2193-8210 2190-9172 |
| language | English |
| last_indexed | 2024-12-18T02:21:01Z |
| publishDate | 2020-07-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Dermatology and Therapy |
| spelling | doaj.art-2f83c6b9de364f3cb98f98f30b394cb52022-12-21T21:24:13ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722020-07-0110590391510.1007/s13555-020-00425-4Management Pearls on the Treatment of Actinic Keratoses and Field CancerizationJaime Piquero-Casals0Daniel Morgado-Carrasco1Yolanda Gilaberte2Rubén Del Rio3Antonio Macaya-Pascual4Corinne Granger5José Luis López-Estebaranz6Dermik Clinica Dermatológica MultidisciplinarDermatology Department, Hospital Clínic de Barcelona, Universitat de BarcelonaDermatology Department, Instituto de Investigación Sanitaria (IIS) Aragón, Miguel Servet University HospitalDermatology Department, Hospital de L’Esperit SantDermatology Department, Hospital Universitari BellvitgeInnovation and Development, ISDINDermatology Department, Hospital Universitario Fundación AlcorcónAbstract Field cancerization (FC) is a chronic disease involving multiple clinical and subclinical actinic keratoses (AK) on large photo-exposed surfaces with multifocal areas of dysplasia and precancerous changes. Patients and treatment must be properly monitored and managed to avoid aggravation and progression of the disease. Management of actinic keratoses includes lesion-directed treatments, such as cryotherapy and field-directed therapies. Field-directed therapies may have the potential to address subclinical damage, reduce AK recurrence rates and potentially reduce the risk of squamous cell carcinoma development. Multiple studies have demonstrated the efficacy of field-directed treatments, including 5-fluorouracil, photodynamic therapy, imiquimod, chemical exfoliation with trichloroacetic acid and diclofenac gel, for multiple AK and FC. The choice of therapy should be based on multiple factors, such as efficacy, tolerability, patient risk profile, costs and cosmetic results. Management of AK includes not only treatment but also prevention. Medical devices, such as sunscreens containing liposome-encapsulated DNA repair enzymes, can repair DNA damage associated with chronic UV radiation and reduce the number of new AK lesions. Here we provide therapeutic pearls and expert opinions on the treatment of AK and FC (as monotherapy or in combination) with the overall aim to achieve better, faster, and well-tolerated clinical responses.https://doi.org/10.1007/s13555-020-00425-4Actinic keratosisChemical peelsCutaneous field cancerizationPhotoagingPhoto-carcinogenesisPhotodynamic therapy |
| spellingShingle | Jaime Piquero-Casals Daniel Morgado-Carrasco Yolanda Gilaberte Rubén Del Rio Antonio Macaya-Pascual Corinne Granger José Luis López-Estebaranz Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization Dermatology and Therapy Actinic keratosis Chemical peels Cutaneous field cancerization Photoaging Photo-carcinogenesis Photodynamic therapy |
| title | Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization |
| title_full | Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization |
| title_fullStr | Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization |
| title_full_unstemmed | Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization |
| title_short | Management Pearls on the Treatment of Actinic Keratoses and Field Cancerization |
| title_sort | management pearls on the treatment of actinic keratoses and field cancerization |
| topic | Actinic keratosis Chemical peels Cutaneous field cancerization Photoaging Photo-carcinogenesis Photodynamic therapy |
| url | https://doi.org/10.1007/s13555-020-00425-4 |
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