Primary Care Review of Actinic Keratosis and Its Therapeutic Options: A Global Perspective

Abstract

Actinic keratosis (AK) is a common skin condition caused by long-term sun exposure that has the potential to progress to non-melanoma skin cancers. The objective of this review is to examine the therapeutic options and management of AK globally, particularly in Australia, Canada, and the United Kingdom. Despite its potentially malignant nature, general awareness of AK is low, both in the general population and in the primary health care setting, especially in countries with low incidence. There is no standard therapeutic strategy for AK; it is treated through a variety of lesion-directed or field-directed therapies or a combination of both. A variety of treatment options are used depending on the experience of the primary care physician, the pathology of the lesion, and patient factors. Studies have shown that the physicians do not always use the optimal treatment option because of a lack of knowledge. The higher incidence of AK in fair-skinned people in Australia has resulted in well-established management strategies and guidelines for its treatment, compared with countries with lower incidence. It is essential to raise the awareness of AK because of its potential to progress to invasive squamous cell carcinoma. Primary care physicians are often the first to see this condition in their patients and are perfectly placed to educate the public and raise awareness. It is therefore desirable that their education and knowledge about AK and its treatment are up to date.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-015-0070-9) contains supplementary material, which is available to authorized users.

Ingenol mebutate in low amounts for the treatment of actinic keratosis in Korean patients

“…Nevertheless, the reason why AK should be treated is because we cannot predict which AK will transform into an invasive SCC. Various therapeutic approaches have been used for the treatment of AKs, including lesion-specific therapies, such as cryotherapy, laser therapy, and curettage, as well as field-directed therapies, such as imiquimod and topical photodynamic therapy 14–16. While deciding on the treatment method, a number of factors should be considered.…”

Patient satisfaction and reported outcomes on the management of actinic keratosis

“…Epidermal keratinocytes, which characteristically die at −40°C to −50°C, are destroyed by this freezing approach 38. This quick and relatively simple therapeutic strategy is a common first-line approach for AK treatment 39. In a multicenter randomized, intraindividual (right–left) study, 119 subjects from both genders participated in telephone calls at weeks 1 and 13 to assess patient overall preference and lesion response to cryotherapy in comparison with MAL-PDT 40.…”

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

“…In general patients develop multiple AKs in one area and predicting which course each individual lesion will follow is impossible. Nonetheless, AK lesions are reliable markers for patients who are most predisposed to developing invasive SCC [4,[12][13].AK lesions typically appear in areas most frequently exposed to the sun such as the face, back of the hands, or bald scalp; 75% of lesions are found on the head, neck and forearms [14]. The lesions vary in appearance as well as size and can include erythematous scaly macules, rough pigmented patches and hyperkeratotic skin horns.…”

“…AK lesions typically appear in areas most frequently exposed to the sun such as the face, back of the hands, or bald scalp; 75% of lesions are found on the head, neck and forearms [14]. The lesions vary in appearance as well as size and can include erythematous scaly macules, rough pigmented patches and hyperkeratotic skin horns.…”