Liquid Nitrogen: Temperature Control in the Treatment of Actinic Keratosis

Goldberg, Leonard Harry; Kaplan, Baruch; Vergilis-Kalner, Irene J.; Landau, Jennifer M.

doi:10.1111/j.1524-4725.2010.01804.x

Cited by 27 publications

(25 citation statements)

References 15 publications

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“…1 Cryotherapy with liquid nitrogen is the most widely used therapy for actinic keratoses. 2 This treatment may be associated with significant recurrence rates in the area treated because therapy is aimed only at the individual actinic keratoses, socalled spot therapy. Several other therapies are applied to an entire field of sundamaged skin, so-called field therapy.…”

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confidence: 99%

Long-term Follow-up Study of Ingenol Mebutate Gel for the Treatment of Actinic Keratoses

Lebwohl¹,

Shumack²,

Gold³

et al. 2013

JAMA Dermatol

118

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Importance: Ingenol mebutate is the active agent (a macrocyclic diterpene ester) in the sap of the plant Euphorbia peplus. This herb has been used as a traditional remedy for several different skin lesions, including skin cancers.Objective: To assess 12-month recurrence rates and safety associated with ingenol mebutate gel treatment in patients who previously had achieved complete clearance of actinic keratoses. Design and Setting:The treatment area was observed for recurrence for 12 months after the original study. Patients were treated in an outpatient setting.Participants: Patients received ingenol mebutate gel, 0.015%, daily for 3 consecutive days for actinic keratoses on the face or scalp or ingenol mebutate gel, 0.05%, daily for 2 consecutive days for actinic keratoses on the trunk or extremities. Study participants had achieved complete clearance in a prespecified 25-cm 2 area at day 57 of their original trial. Main Outcome Measures:Recurrence rates and safety were assessed.Results: In total, 108 patients with complete clearance of face or scalp lesions in the original trial and 76 patients with complete clearance of trunk or extremity lesions in the original trial were enrolled in the 12-month observational follow-up study. Of these, 100 patients (face or scalp) and 71 patients (trunk or extremities) completed all 12 months. The sustained lesion reduction rates compared with baseline were 87.2% for the face or scalp and 86.8% for the trunk or extremities. The estimated median times to recurrence were 365 days (face or scalp) and 274 days (trunk or extremities). There were no safety concerns during the follow-up period. Conclusion and Relevance:Ingenol mebutate gel applied as field therapy for 2 or 3 consecutive days to treat actinic keratoses produced clinically relevant sustained clearance and long-term lesion reduction.

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confidence: 99%

Long-term Follow-up Study of Ingenol Mebutate Gel for the Treatment of Actinic Keratoses

Lebwohl¹,

Shumack²,

Gold³

et al. 2013

JAMA Dermatol

118

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“…A longer treatment time (10-15 s) has been proposed when performing cryosurgery for thicker or hyperkeratotic lesions. [33][34][35] Previously reported recurrence rates in a larger (n = 470) study of 0.5% 5-FU/SA were 8.4% and 14.2% at 6 and 12 months, respectively, after the end of treatment. 17,18 The AKs in this previous study were located on the face/forehead or bald scalp and were mild/moderate (grade I/II) only; 0.5% 5-FU/SA was applied for up to 12 weeks.…”

Section: Discussionmentioning

confidence: 97%

A prospective randomized exploratory study comparing the efficacy of once‐daily topical 0.5% 5‐fluorouracil in combination with 10.0% salicylic acid (5‐FU/SA) vs. cryosurgery for the treatment of hyperkeratotic actinic keratosis

Simon

Dominicus

Karl³

et al. 2014

Acad Dermatol Venereol

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A prospective randomized exploratory study comparing the efficacy of once-daily topical 0.5% 5-fluorouracil in combination with 10.0% salicylic acid (5-FU/SA) vs. cryosurgery for the treatment of hyperkeratotic actinic keratosis Mean change in lesion count from baseline to Day 98 was À5.2 and À5.7 lesions per patient for 0.5% 5-FU/SA and cryotherapy groups respectively. Histological AK clearance rates on Day 98 were 62.1% and 41.9% respectively. At 6-month posttreatment follow-up, recurrence of cleared lesions (no clinically visible lesions in treatment area) occurred in 39.4% of 0.5% 5-FU/SA and 84.8% of cryosurgery patients. Drug-related adverse events (AEs), including local skin reactions considered 'severe' by the investigator, were reported in 24.2% of 0.5% 5-FU/SA and 6.1% of cryosurgery patients. All drug-related AEs were skin reactions.Conclusions Although the study was not powered to explore statistical differences in clinical efficacy between treatments, a short (6-week) schedule of topical treatment with 0.5% 5-FU/SA achieved greater histological clearance and lower recurrence of grade II/III hyperkeratotic AKs than cryosurgery. AE incidence across both treatment groups was relatively low and AEs were generally mild or moderate. Clinical trials.gov identifier: NCT01358851.

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“…Cryospray with liquid nitrogen has been used successfully in many other medical applications including cervical dysplasia, early skin cancers and warts, oral leukoplakia and respiratory tract papillomas and tumors [15][16][17]. Thus, the application in the esophagus since its introduction in the past decade has other areas of experience from which to learn.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Durability of Cryospray Ablation for Dysplastic Barrett’s Esophagus

Sreenarasimhaiah¹

2014

J Gastroint Dig Syst

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Liquid Nitrogen: Temperature Control in the Treatment of Actinic Keratosis

Abstract: Cryotherapy with an integrated sensor for temperature control is an effective, safe, and precise treatment, allowing for a 100% short-term cure rate of AKs.

Cited by 27 publications

References 15 publications

Long-term Follow-up Study of Ingenol Mebutate Gel for the Treatment of Actinic Keratoses

Long-term Follow-up Study of Ingenol Mebutate Gel for the Treatment of Actinic Keratoses

A prospective randomized exploratory study comparing the efficacy of once‐daily topical 0.5% 5‐fluorouracil in combination with 10.0% salicylic acid (5‐FU/SA) vs. cryosurgery for the treatment of hyperkeratotic actinic keratosis

Efficacy and Durability of Cryospray Ablation for Dysplastic Barrett’s Esophagus

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