Clinical Recognition of Actinic Keratoses in a High-Risk Population

Venna, Suraj; Lee, Dennis; Stadecker, Miguel J.; Rogers, Gary S.

doi:10.1001/archderm.141.4.507

Cited by 60 publications

(75 citation statements)

References 17 publications

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“…Dermatologists usually confused AK with seborrhoeic keratosis, basal cell carcinoma, Bowen's disease, or discoid lupus erythematosus. In previous investigations, the positive predictive rate was 74-94% [21,22], much higher than in our study. Such a high misdiagnosis rate may imply a Chinese dermatologists' lack of sufficient attention and awareness to AK.…”

Section: Discussioncontrasting

confidence: 79%

Clinical and Pathological Study of 328 Cases of Actinic Keratosis in Eastern Chinese Patients

Han

Chen²,

Dou³

et al. 2013

Dermatology

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Background: Actinic keratosis (AK) is prevalent and has been widely studied in fair-skinned populations. However, this is not the case in eastern countries. AK in Asians has not been so thoroughly investigated. Objectives: To analyse the clinical and pathological features of a relatively large number of cases of AK diagnosed in older Chinese patients. Methods: Case histories of 328 patients with pathologically diagnosed AK were analysed retrospectively. Their demographic, clinical, pathological and treatment data were collected for analysis of associated factors. Results: Lesions were usually distributed on the face, especially the cheeks and temples. The most frequent pathological type was hypertrophic. Only 34% of the cases had been diagnosed correctly as AK before biopsy; many were mistaken for seborrhoeic keratosis. Conclusions: Most patients were elderly females and there was a higher incidence of lesions on the face, and a lower incidence on the extremities and trunk; this finding contrasts with previous investigations in fair-skinned people.

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Section: Discussioncontrasting

confidence: 79%

Clinical and Pathological Study of 328 Cases of Actinic Keratosis in Eastern Chinese Patients

Han

Chen²,

Dou³

et al. 2013

Dermatology

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“…AK typically arise in areas of chronic sun exposure of the face, neck and forearms and represent one stage in the continuum from subclinical keratinocyte dysplasia to invasive squamous cell carcinoma. The diagnosis of AK is generally based on clinical inspection, and studies have shown positive predictive values for clinical diagnosis between 81 and 94% when compared to histopathologic examination [33,34]. Biopsy with histological evaluation is not routinely performed in the diagnostic work-up for AK, nor is histology generally performed to evaluate treatment efficacy, with the exception of selected outcome studies and for the detection of residual, recurrent or invasive disease.…”

Section: Discussionmentioning

confidence: 99%

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

et al. 2009

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Background: Actinic keratoses (AK) represent cutaneous carcinoma in situ and have previously been evaluated by reflectance confocal microscopy (RCM). Treatment of AK with imiquimod (IMIQ) 5% cream has been shown to ‘highlight’ subclinical lesions. Objective: The aim of this study was to test the applicability of RCM for noninvasive monitoring of actinic field cancerization and detection of subclinical AK. Subjects and Methods: AK and surrounding skin sites with no apparent AK of 11 volunteers were selected for imaging and subsequently classified as ‘clinical’ and ‘subclinical’ AK. IMIQ was used 3 times weekly for 4 weeks. Results: RCM was able to detect morphologic features of AK in both clinical and subclinical AK; features were more pronounced in clinical lesions. The immunomodulatory response induced by IMIQ was visualized by RCM. Conclusion: Our findings indicate that RCM allows noninvasive monitoring of treatment response in vivo and permits early detection of subclinical AK, thus substantiating the incentive for therapy.

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“…Histological evaluation at 3 month revealed recurrence in three patients treated with laser resurfacing, however, clinically, a recurrence was seen in five patients in the same group. This suggests that recurrence rates can be overestimated, and probably also underestimated, and that histological investigation is essential to determine the efficacy of the treatment [35]. In most studies, however, no histological examinations before and/or after treatment are performed [17,18,21,23].…”

Section: Discussionmentioning

confidence: 99%

A clinical comparison and long‐term follow‐up of topical 5‐fluorouracil versus laser resurfacing in the treatment of widespread actinic keratoses

et al. 2006

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Clinical Recognition of Actinic Keratoses in a High-Risk Population

Cited by 60 publications

References 17 publications

Clinical and Pathological Study of 328 Cases of Actinic Keratosis in Eastern Chinese Patients

Clinical and Pathological Study of 328 Cases of Actinic Keratosis in Eastern Chinese Patients

Reflectance Confocal Microscopy for Noninvasive Monitoring of Therapy and Detection of Subclinical Actinic Keratoses

A clinical comparison and long‐term follow‐up of topical 5‐fluorouracil versus laser resurfacing in the treatment of widespread actinic keratoses

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