Italian expert consensus paper on the management of patients with actinic keratoses.
0.5% 5-FU (fluoro uracil)-salicylic acid
ALA and MAL PDT
actinic keratosis
cancerization field
imiquimod cream (3.75% and 5%)
ingenol mebutate gel
nicotinamide
organ transplant recipients
systemic retinoids
topical treatment
Journal
Dermatologic therapy
ISSN: 1529-8019
Titre abrégé: Dermatol Ther
Pays: United States
ID NLM: 9700070
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
25
05
2020
revised:
25
06
2020
accepted:
07
07
2020
pubmed:
11
7
2020
medline:
29
4
2021
entrez:
11
7
2020
Statut:
ppublish
Résumé
Two round tables involving experts were organized in order to reach a consensus on the management of patients with actinic keratosis (AK). In the first, seven clinical questions were selected and analyzed by a systematic literature review, using a Population, Intervention, Control, and Outcomes framework; in the second, the experts discussed relevant evidences and a consensus statement for each question was developed. Consensus was reached among experts on how to best treat AK patients with respect to different clinical scenarios and special populations. Lesion-directed treatments are preferred in patients with few AKs. Patients with multiple AKs are challenging, with more than one treatment usually needed to achieve complete lesion clearance or a high lesion response rate, therapy should be personalized, based on previous treatments, patient, and lesion characteristics. Methyl aminolevulinate-PDT, DL (day light) PDT, and imiquimod cream were demonstrated to have the lowest percentage of new AKs after post treatment follow-up. For IMQ 5% and 3.75%, a higher intensity of skin reactions is associated with higher efficacy. Photodynamic therapy (PDT) is the most studied treatment for AKs on the arms. Regular sunscreen use helps preventing new AKs. Oral nicotinamide 500 mg twice daily, systemic retinoids and regular sunscreen use were demonstrated to reduce the number of new squamous cell carcinomas in patients with AKs. Limited evidence is available for the treatment of AKs in organ transplant recipients. There is no evidence in favor or against the use of any of the available treatments in patients suffering from hematological cancer.
Substances chimiques
Photosensitizing Agents
0
Aminolevulinic Acid
88755TAZ87
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13992Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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