Effectiveness and safety of 0·5% colchicine cream vs. photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratosis and skin field cancerization of the forearms: a randomized controlled trial

Miola, Anna Carolina; Ferreira, Eliane Roio; Lima, Thania Rios Rossi; Schmitt, Juliano Vilaverde; Abbade, Luciana Patrícia Fernandes; Miot, Hélio Amante

doi:10.1111/bjd.16824

Cited by 21 publications

(14 citation statements)

References 39 publications

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“…Limited evidence is available on the efficacy of AK treatments for lesions located on the arms that fulfills the inclusion criteria for the present research. 5,[41][42][43][44][45][46] The majority of studies investigated PDT (with ALA or MAL), some of the treatments are off-label for the use on the arms.…”

Section: Question 3: In a Patient With Multiple Aks On The Arms Whmentioning

confidence: 99%

Italian expert consensus paper on the management of patients with actinic keratoses

Moscarella

Brizzi

Casari

et al. 2020

Dermatologic Therapy

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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. K E Y W O R D S 0.5% 5-FU (fluoro uracil)-salicylic acid, actinic keratosis, ALA and MAL PDT, cancerization field, imiquimod cream (3.75% and 5%), ingenol mebutate gel, nicotinamide, organ transplant recipients, systemic retinoids, topical treatment

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Section: Question 3: In a Patient With Multiple Aks On The Arms Whmentioning

confidence: 99%

Italian expert consensus paper on the management of patients with actinic keratoses

Moscarella

Brizzi

Casari

et al. 2020

Dermatologic Therapy

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“…The histological characterization of SFC should provide additional contributions to the AK count, quality of life scales, and clinical severity scores4, 35, 36 in understanding the underlying phenomena of SFC. These findings are being tested in clinical trials of SFC treatments such as photodynamic therapy, 37 ingenol mebutate, and 5-fluorouracil, and according to a scale of severity of AKs in development for the present authors’ SFC study group.…”

Section: Discussionmentioning

confidence: 99%

Contribution to characterization of skin field cancerization activity: morphometric, chromatin texture, proliferation, and apoptosis aspects

Miola

Castilho

Schmitt

et al. 2019

Anais Brasileiros de Dermatologia

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BackgroundA skin field cancerization is a cutaneous area with subclinical changes resultant from chronic sun exposure, with a higher predisposition to development of pre-neoplastic and neoplastic lesions. So far, there are no well-defined objective parameters that can indicate their degree of activity.ObjectivesTo describe and compare morphometric aspects and expression of factors related to apoptosis and cell proliferation in actinic keratosis (AK), in both photoexposed and photoprotected epidermis.MethodsA cross-sectional study of patients with actinic keratosis in the forearms, biopsied at two points: the actinic keratosis and the axillary region. The biopsies of the actinic keratosis, perilesional area, and axilla were evaluated through keratinocyte intraepithelial neoplasia (KIN), and immunohistochemistry of p53, survivin, and Ki67. Nuclear morphometry of basal layer cells was performed through digital image analysis: entropy, area, perimeter, Ra, fractal dimension, circularity, color intensity, and largest diameter.ResultsThere were 13 patients included and 38 actinic keratosis biopsied. In morphometry, 1039 nuclei were analyzed, of which 228 represented axillary skin, 396 demonstrated actinic keratosis, and 415 represented the perilesional area to the actinic keratosis. There was a significant difference (p < 0.05) in all variables tested for the topographies evaluated. A significant correlation was identified between nucellar morphometric elements, KIN, proliferation markers, and apoptosis. Joint patterns of p53, Ki67, and KIN discriminated the topographies sampled.Study limitationsThis was a cross-sectional study with a small number of patients.ConclusionsThere are patterns of proliferation, resistance to apoptosis, and different cellular morphometrics between photoprotected skin and photoexposed skin. The joint expression of p53, Ki67, and KIN can characterize skin field cancerization activity.

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“…These last two options demand supervision by an experienced statistics professional. [26][27][28][29] Measurement instruments comprising items with ordinal scores (for example, quality of life surveys) should be assessed for dimensionality and can be more adequately analyzed using models based on item response theory for ordinal data. 30,31 Finally, there is a certain degree of controversy with relation to exclusive use of ordinal statistical technique (non-parametric methods) for all cases, because of their lower statistical power compared to parametric techniques.…”

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confidence: 99%

Análise de dados ordinais em estudos clínicos e experimentais

Miot

2020

J. vasc. bras.

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Effectiveness and safety of 0·5% colchicine cream vs. photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratosis and skin field cancerization of the forearms: a randomized controlled trial

Abstract: COL 0·5% cream and MAL-PDT are safe and effective for treating SFC.

Cited by 21 publications

References 39 publications

Italian expert consensus paper on the management of patients with actinic keratoses

Italian expert consensus paper on the management of patients with actinic keratoses

Contribution to characterization of skin field cancerization activity: morphometric, chromatin texture, proliferation, and apoptosis aspects

Análise de dados ordinais em estudos clínicos e experimentais

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