Pharmacotherapy of actinic keratosis: an update

Berman, Brian; Amini, Sadegh

doi:10.1517/14656566.2012.716039

Cited by 29 publications

(40 citation statements)

References 153 publications

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“…Among numerous therapies for AK, ablative and/or surgical procedures (surgery, cryotherapy, laser therapy and photodynamic therapy [PDT]) are the mainstay of lesion-directed therapy, while topical treatments such as diclofenac/hyaluronic acid (HA), imiquimod, 5-fluorouracil (5-FU), ingenol mebutate and PDT are applicable in field-directed therapy [7,8]. …”

Section: Introductionmentioning

confidence: 99%

In vivo Reflectance Confocal Microscopy Characterization of Field-Directed 5-Fluorouracil 0.5%/Salicylic Acid 10% in Actinic Keratosis

Ulrich¹,

Alarcón²,

Malvehy³

et al. 2015

Dermatology

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Actinic keratosis (AK), a frequently diagnosed cutaneous neoplasm in individuals with chronic sun exposure or fair skin, is a risk factor for squamous cell carcinoma. AK presents as clinically visible lesions and/or as subclinical lesions where an entire field of area (field cancerization) contains lesions of various grades. The diagnosis and surveillance of subclinical AK is challenging. We report a new AK management approach, including subclinical AK, with noninvasive in vivo reflectance confocal microscopy (RCM) monitoring of field-directed topical 5-fluorouracil 0.5%/salicylic acid 10.0% (5-FU/SA; currently approved for single lesions). In this case series, eight patients with primarily recurrent, multiple AKs received ≤6 weeks of field-directed 5-FU/SA; complete clearance of clinical/subclinical AKs on various body areas was shown in most patients using RCM. RCM facilitated the detection/characterization of subclinical AKs in the setting of field cancerization. Topical field-directed 5-FU/SA monitored with RCM is a promising management approach for subclinical AKs.

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Section: Introductionmentioning

confidence: 99%

In vivo Reflectance Confocal Microscopy Characterization of Field-Directed 5-Fluorouracil 0.5%/Salicylic Acid 10% in Actinic Keratosis

Ulrich¹,

Alarcón²,

Malvehy³

et al. 2015

Dermatology

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“…Treatment options for AKs include a wide range of ablative modalities and topical treatments such as diclofenac sodium gel, imiquimod, ingenol mebutate gel or 5-fluorouracil with salicylic acid. Diclofenac sodium 3% gel is a non-steroidal anti-inflammatory topical agent that demonstrates preferential inhibition of cyclo-oxygenase-2 (COX-2), an enzyme implicated in ultraviolet (UV)-induced skin carcinogenesis (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The treatment of AKs with topical 3% diclofenac in 2.5% hyaluronic acid (Solaraze ® , Almirall, S.A., Barcelona, Spain) has been extensively documented in the last decade (17).…”

mentioning

confidence: 99%

Monitoring Treatment of Field Cancerisation with 3% Diclofenac Sodium 2.5% Hyaluronic Acid by Reflectance Confocal Microscopy: A Histologic Correlation

Malvehy¹,

Roldán–Marín²,

Iglesias-García³

et al. 2015

Acta Derm Venerol

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Visual inspection may fail to accurately evaluate field cancerisation (subclinical actinic keratoses [AKs]). We aimed to describe field cancerisation by confocal reflectance microscopy and changes induced by the application of 3% diclofenac sodium gel in 2.5% hyaluronic acid. Fourteen male patients, > 50 years old, with AKs on the bald scalp were included. Clinical examination, confocal microscopy and histological study of clinically visible lesions and "normal appearing" adjacent skin before and after treatment was completed. Reflectance confocal microscopy showed a decrease in scaling (p = 0.001) and atypia of the honeycomb pattern (p = 0.001) at 2 weeks of treatment. Changes in parakeratosis, inflammation and dermal collagen remodelling were also observed. Histology correlated with confocal features in AK and subclinical AK. Reflectance confocal microscopy was useful in the evaluation of field cancerisation and monitoring of treatment response. A rapid improvement in epidermal atypia was observed.

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“…Although it is quick and easy to perform, and does not require local anaesthesia, it does not allow histological examination of tissue, and it is only suitable for treating a few lesions at a time; thinner lesions have a higher response rate than thicker ones 14–16. It does not address adjacent field changes in the skin, where new lesions may develop over time 17.…”

Section: Treatment Strategiesmentioning

confidence: 99%

“…near eyes or mouth, where topical treatments are difficult to apply), where histology is required (e.g. carcinoma is suspected) or for recurrent lesions 1,4,14. These methods require local anaesthesia and may leave epidermal changes or scarring 4,14.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Management of actinic keratosis

2013

DTB

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Actinic keratoses are common, often multiple, epidermal lesions found mainly on the sun-exposed skin of fair-skinned middle-aged and older people.(1) Over time, lesions may remain unchanged or may proliferate, regress, reappear or develop into squamous cell carcinoma (SCC).(2) Detectable (spot) lesions are often associated with alteration of the surrounding skin (field) where subclinical lesions might be present.(2) Interventions may target individual or multiple lesions or a whole field.(2) Here, we update our previous review(3) on the prevention and treatment of actinic keratoses, focusing on the licensed treatments most commonly used in the UK and recommended in UK guidelines.

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Pharmacotherapy of actinic keratosis: an update

Cited by 29 publications

References 153 publications

In vivo Reflectance Confocal Microscopy Characterization of Field-Directed 5-Fluorouracil 0.5%/Salicylic Acid 10% in Actinic Keratosis

In vivo Reflectance Confocal Microscopy Characterization of Field-Directed 5-Fluorouracil 0.5%/Salicylic Acid 10% in Actinic Keratosis

Monitoring Treatment of Field Cancerisation with 3% Diclofenac Sodium 2.5% Hyaluronic Acid by Reflectance Confocal Microscopy: A Histologic Correlation

Management of actinic keratosis

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