Interventions for actinic keratoses

Abstract

For individual lesions, photodynamic therapy appears more effective and has a better cosmetic outcome than cryotherapy. For field-directed treatments, diclofenac, 5-fluorouracil, imiquimod, and ingenol mebutate had similar efficacy, but their associated adverse events and cosmetic outcomes are different. More direct comparisons between these treatments are needed to determine the best therapeutic approach.

Transfersomes as versatile and flexible nano-vesicular carriers in skin cancer therapy: the state of the art

“…This rate amplified to 34.1 and 18.2% in men and women aged above 70 years [85]. The study set up to investigate the occurrence of AK was better in individuals with red hair and freckles, which indicates Fitzpatrick skin type I.​ There was a similar, but extra-marked, boost reported in Australia; prevalence rates of AK were 22 and 8% for men and women aged 30–39 years, which increased to 83 and 64%, respectively, in adults aged 60–69 years [86]. One reason for the greater incidence rate in males might be that it is more possible for them to labor outdoors and have more sun contact.…”

Cáncer de piel: Una realidad cotidianamente ignorada.

“…Además de la intensidad y el tiempo de exposición a los RUV, rasgos constitucionales como el fenotipo y el grado de sensibilidad cutánea frente a la RUV (fototipo) son factores de riesgo para desarrollar la enfermedad (37,38). Los individuos de piel clara, de ojos claros, de pelo rubio o pelirrojo y que poseen fototipo I y II (quemaduras solares frecuentes y poca capacidad de bronceo) son el grupo expuesto a mayor riesgo (39).…”

“…Los pacientes inmunosuprimidos, especialmente los trasplantados, tienen un riesgo aumentado de presentar queratosis actínicas y otros cánceres de piel (67). También lo tienen pacientes con vitiligo y ciertas genodermatosis (albinismo, xeroderma pigmentoso, epidermodisplasia verruciforme, Rothmund Thomson y Bloom) (68).…”

Topical agents for preventing and treating actinic keratosis

“…10 At the recommended dose of 0.5g of gel per 25cm 2 , a course of treatment for such an 12 Meta-analysis of seven trials, including one involving immunosuppressed patients, showed that the number needed to treat (NNT) to achieve the outcome "completely improved" for diclofenac 3% gel com- pared with the vehicle (hyaluronic acid gel) alone was three to five, with no significant difference between 60-day and 90-day treatment periods. 13 Trials evaluating efficacy on the scalp, arm/forearms and back of the hands reported more variable results than those assessing lesions on the face or forehead.…”

“…A Cochrane review evaluated topical and other treatments for AK. 13 Its analysis of 83 randomised trials comparing treatments with placebo, vehicle or another active therapy and involving approximately 10,000 patients found that the quality of most studies had methodological flaws affecting outcomes. Of the topical field therapies, efficacy was similar for diclofenac, fluorouracil, imiquimod and ingenol mebutate, but their associated adverse events and cosmetic outcomes were different; a "significant number" of patients discontinued treatment because of adverse events.…”