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SummaryBackgroundThe increasing incidence of actinic keratosis (AK) is causing a large burden on healthcare systems. The current management of patients with AK seems to vary within and between primary and secondary care; however, an in‐depth understanding of healthcare providers’ management of AK is currently lacking.ObjectivesTo gain insight into the management of AK by exploring the underlying motives of current practices among general practitioners (GPs) and dermatologists in the Netherlands.MethodsA qualitative study was conducted consisting of semistructured individual interviews with 22 GPs and 18 dermatologists focusing on the underlying motives regarding AK management. A predefined topic list was used. All interviews were audiotaped, transcribed verbatim and inductively analysed by two researchers drawing on elements of grounded theory.ResultsGPs reported conducting limited proactive clinical assessments of cutaneous photodamage due to a perceived lack of value, varying in their method of diagnosing AK. They mainly applied cryotherapy or referred to secondary care due to lack of experience, varying in their applications and providing mostly patient‐driven follow‐up care. They also reported a great need for guidelines due to a lack of knowledge of AK management. Dermatologists indicated pursuing proactive clinical assessments of cutaneous photodamage and the goal of providing guideline‐driven AK care. However, patient preferences still largely influence both treatment choices and follow‐up regimens. Furthermore, dermatologists reported the need to improve AK and skin cancer management in primary care.ConclusionsFor AK care to become more standardized and uniform in Dutch primary care, the implementation of guidelines and (continuing) education are needed to address the commonly reported barriers of lack of value, experience and knowledge among GPs. For efficient use of care among dermatologists, shared decision‐making tools along with adequate (framing of) patient information may be useful.

Background: Only around 60% of skin lesions excised by GPs are referred to a pathologist. Clinical diagnoses of skin excisions by GPs may not be very accurate. Subcutis excisions are rarely done by GPs, and there is hence little information in the literature on the histopathological yield of subcutis excisions by GPs with regard to malignancies.

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Summary Actinic keratoses (AK) are rough skin lesions (patches) caused by long‐term sun exposure in light skinned individuals, affecting 24‐60% of people above the age of 50. The current management of AK patients (meaning how they are diagnosed and treated and how long they are ‘followed up’ for) seems to vary within and between primary care (e.g. GPs) and secondary care (e.g. hospital dermatology departments). This Dutch study aimed to provide insight into underlying motives of current AK management. A study was conducted consisting of interviews with 22 general practitioners (GPs) and 18 dermatologists. GPs varied in their methods for diagnosing AK and in determining treatment and follow‐up schedules, due to a lack of knowledge and experience and low perceived value of AK care. Dermatologists indicated that they strived to provide AK care according to official guidelines, although patient preferences and other patient‐related factors influence treatment choices and often lead to extensive follow‐up regimens. For AK care to become more standardized and uniform in Dutch primary care, implementation of guidelines and continuing education are needed, to address the commonly reported barriers of lack of value, experience and knowledge among GPs. To help prevent extensive follow‐up in secondary care (and therefore to ensure efficient use of care), shared decision‐making tools along with adequate patient information may be useful to help dermatologists’ management of patient preferences.