Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Chetty P, Choi F, Mitchell T. Primary care review of actinic keratosis and its therapeutic options: a global perspective. Dermatol Ther (Heidelb) 2015;5:19-35. [PMID: 25647448 PMCID: PMC4374063 DOI: 10.1007/s13555-015-0070-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Indexed: 12/21/2022] Open

For:	Chetty P, Choi F, Mitchell T. Primary care review of actinic keratosis and its therapeutic options: a global perspective. Dermatol Ther (Heidelb) 2015;5:19-35. [PMID: 25647448 PMCID: PMC4374063 DOI: 10.1007/s13555-015-0070-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Indexed: 12/21/2022] Open

Number

Cited by Other Article(s)

Li Z, Lu F, Zhou F, Song D, Chang L, Liu W, Yan G, Zhang G. From actinic keratosis to cutaneous squamous cell carcinoma: the key pathogenesis and treatments. Front Immunol 2025;16:1518633. [PMID: 39925808 PMCID: PMC11802505 DOI: 10.3389/fimmu.2025.1518633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 01/09/2025] [Indexed: 02/11/2025] Open

Affiliation(s)

Zhenlin Li School of Medicine, Anhui University of Science and Technology, Huainan, China Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
Fangqi Lu School of Medicine, Anhui University of Science and Technology, Huainan, China Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
Fujin Zhou School of Medicine, Anhui University of Science and Technology, Huainan, China Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
Dekun Song School of Medicine, Anhui University of Science and Technology, Huainan, China Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
Lunhui Chang School of Medicine, Anhui University of Science and Technology, Huainan, China Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
Weiying Liu Department of Dermatology, Hunan Aerospace Hospital, Changsha, China
Guorong Yan Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China
Guolong Zhang School of Medicine, Anhui University of Science and Technology, Huainan, China Department of Phototherapy, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Skin Cancer Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China Institute of Photomedicine, School of Medicine, Tongji University, Shanghai, China

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Mahmud MS, Paul BK, Hasan MR, Islam KT, Mahmud I, Mahmud S. Computational network analysis of two popular skin cancers provides insights into the molecular mechanisms and reveals common therapeutic targets. Heliyon 2025;11:e41688. [PMID: 39866430 PMCID: PMC11761328 DOI: 10.1016/j.heliyon.2025.e41688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Revised: 01/02/2025] [Accepted: 01/02/2025] [Indexed: 01/28/2025] Open

Abstract

Basal Cell Carcinoma (BCC) and Actinic Keratosis (AK) are prevalent skin conditions with significant health complications. The molecular mechanisms underlying these conditions and their potential shared pathways remain ambiguous despite their prevalence. Therefore, this study aims to elucidate the common molecular pathways and potential therapeutic targets for BCC and AK through comprehensive computational network analysis. Linkage analysis was performed to identify common liable genes between BCC and AK. Protein-protein interactions (PPIs), Topological properties, GO enrichment, pathway enrichment, and gene regulatory network analyses were also performed to reveal potential molecular mechanisms and pathways. Furthermore, we evaluated protein-drug interactions (PDIs) to identify potential therapeutic targets. Our analysis revealed 22 common genes between BCC and AK: TP53, EGFR, CDKN2A, MMP9, PTGS2, VDR, BCL2, MMP2, EZH2, TP63, FOXP3, MSH2, MMP14, FLG, MC1R, CDKN2B, TIMP3, TYR, SOX10, IRF4, KRT17, and NID1. PPI network analysis highlighted TP53 and EGFR as central hubs, validated using RNA-seq data. Co-expression and physical interaction analysis revealed a strong interplay between the common genes at the transcriptional and functional levels. GO analysis identified skin cancer-relevant terms: "skin development", "immune system development", and "response to radiation" as significantly enriched biological processes, while pathway enrichment analysis highlighted several cancer-related pathways enrichment. Gene regulatory network analysis revealed complex interactions between genes, miRNAs, and transcription factors, with TP53, BCL2, and EGFR playing central roles. PDI network analysis identified ibuprofen as a potential therapeutic agent targeting PTGS2 and BCL2, while other proteins VDR, MMP2, MMP9, and TYR showed interactions with multiple drugs. This computational analysis provides valuable insights into the shared molecular mechanisms of BCC and AK, revealing common pathways and potential therapeutic targets for developing novel treatment strategies and repurposing existing drugs for these prevalent skin cancers. Therefore, these findings may guide future research in understanding and developing targeted therapies for both conditions.

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Kandolf L, Peris K, Malvehy J, Mosterd K, Heppt MV, Fargnoli MC, Berking C, Arenberger P, Bylaite-Bučinskiene M, Del Marmol V, Dirschka T, Dreno B, Forsea AM, Harwood CA, Hauschild A, Heerfordt IM, Kauffman R, Kelleners-Smeets N, Lallas A, Lebbe C, Leiter U, Longo C, Mijušković Ž, Pellacani G, Puig S, Saiag P, Šitum M, Stockfleth E, Salavastru C, Stratigos A, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes). J Eur Acad Dermatol Venereol 2024;38:1024-1047. [PMID: 38451047 DOI: 10.1111/jdv.19897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]

Abstract

A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.

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Affiliation(s)

Lidija Kandolf Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
Ketty Peris UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
Josep Malvehy Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
Klara Mosterd Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
Markus V Heppt Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
Maria Concetta Fargnoli Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Carola Berking Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
Petr Arenberger Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic
Matilda Bylaite-Bučinskiene Clinic of Infectious Diseases and Dermatovenereology, Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania
Veronique Del Marmol Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
Thomas Dirschka Faculty of Health, University Witten-Herdecke, Witten, Germany CentroDerm Clinic, Wuppertal, Germany
Brigitte Dreno Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
Ana-Maria Forsea Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Catherine A Harwood Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Axel Hauschild Department of Dermatology, University Hospital (UKSH), Kiel, Germany
Ida Marie Heerfordt Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
Roland Kauffman Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
Nicole Kelleners-Smeets Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
Aimilios Lallas First Department of Dermatology, Aristotle University, Thessaloniki, Greece
Celeste Lebbe Université Paris Cite, AP-HP Dermato-oncology, Cancer institute APHP, Nord Paris cité, INSERM U976, Saint Louis Hospital, Paris, France
Ulrike Leiter Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
Caterina Longo Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
Željko Mijušković Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
Giovanni Pellacani Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
Susana Puig Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
Philippe Saiag Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, & EA 4340 "Biomarkers in Cancerology and Hemato-Oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
Mirna Šitum Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Eggert Stockfleth Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
Carmen Salavastru Department of Pediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Alexander Stratigos 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
Iris Zalaudek Dermatology Clinic, Maggiore Hospital, Department of Medical Sciences, University of Trieste, Trieste, Italy
Claus Garbe Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany

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Kowalski S, Karska J, Tota M, Skinderowicz K, Kulbacka J, Drąg-Zalesińska M. Natural Compounds in Non-Melanoma Skin Cancer: Prevention and Treatment. Molecules 2024;29:728. [PMID: 38338469 PMCID: PMC10856721 DOI: 10.3390/molecules29030728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open

Campione E, Rivieccio A, Gaeta Shumak R, Costanza G, Cosio T, Lambiase S, Garofalo V, Artosi F, Lozzi F, Freni C, Romeo A, Dika E, Falconi M, Bianchi L. Preliminary Evidence of Efficacy, Safety, and Treatment Satisfaction with Tirbanibulin 1% Ointment: A Clinical Perspective on Actinic Keratoses. Pharmaceuticals (Basel) 2023;16:1686. [PMID: 38139813 PMCID: PMC10748142 DOI: 10.3390/ph16121686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open

Affiliation(s)

Elena Campione Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Antonia Rivieccio Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Ruslana Gaeta Shumak Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Gaetana Costanza Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Terenzio Cosio Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.) Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
Sara Lambiase Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Virginia Garofalo Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Fabio Artosi Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Flavia Lozzi Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
Claudia Freni Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (C.F.); (A.R.); (M.F.)
Alice Romeo Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (C.F.); (A.R.); (M.F.)
Emi Dika Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, DIMEC, University of Bologna, 40126 Bologna, Italy;
Mattia Falconi Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (C.F.); (A.R.); (M.F.)
Luca Bianchi Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)

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Ruiz AJ, Allen R, Giallorenzi MK, Samkoe KS, Shane Chapman M, Pogue BW. Smartphone-based dual radiometric fluorescence and white-light imager for quantification of protoporphyrin IX in skin. JOURNAL OF BIOMEDICAL OPTICS 2023;28:086003. [PMID: 37638107 PMCID: PMC10460113 DOI: 10.1117/1.jbo.28.8.086003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 08/29/2023]

Abstract

Significance

The quantification of protoporphyrin IX (PpIX) in skin can be used to study photodynamic therapy (PDT) treatments, understand porphyrin mechanisms, and enhance preoperative mapping of non-melanoma skin cancers.

Aim

We aim to develop a smartphone-based imager for performing simultaneous radiometric fluorescence (FL) and white light (WL) imaging to study the baseline levels, accumulation, and photobleaching of PpIX in skin.

Approach

A smartphone-based dual FL and WL imager (sDUO) is introduced alongside new radiometric calibration methods for providing SI-units of measurements in both pre-clinical and clinical settings. These radiometric measurements and corresponding PpIX concentration estimations are applied to clinical measurements to understand mechanistic differences between PDT treatments, accumulation differences between normal tissue and actinic keratosis lesions, and the correlation of photosensitizer concentrations to treatment outcomes.

Results

The sDUO alongside the developed methods provided radiometric FL measurements (nW / cm 2 ) with a demonstrated sub nanomolar PpIX sensitivity in 1% intralipid phantoms. Patients undergoing PDT treatment of actinic keratosis (AK) lesions were imaged, capturing the increase and subsequent decrease in FL associated with the incubation and irradiation timepoints of lamp-based PDT. Furthermore, the clinical measurements showed mechanistic differences in new daylight-based treatment modalities alongside the selective accumulation of PpIX within AK lesions. The use of the radiometric calibration enabled the reporting of detected PpIX FL in units of nW / cm 2 with the use of liquid phantom measurements allowing for the estimation of in-vivo molar concentrations of skin PpIX.

Conclusions

The phantom, pre-clinical, and clinical measurements demonstrated the capability of the sDUO to provide quantitative measurements of PpIX FL. The results demonstrate the use of the sDUO for the quantification of PpIX accumulation and photobleaching in a clinical setting, with implications for improving the diagnosis and treatment of various skin conditions.

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Szeimies RM, Dirschka T, Fargnoli MC, Gilaberte Y, Hædersdal M, Chavda R, Calzavara-Pinton P. A Review of MAL-PDT for the Treatment Strategy of Actinic Keratosis: Broader Clinical Perspectives Beyond the Data and Guideline Recommendations. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00936-w. [PMID: 37300793 DOI: 10.1007/s13555-023-00936-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/04/2023] [Indexed: 06/12/2023] Open

Arcuri D, Ramchatesingh B, Lagacé F, Iannattone L, Netchiporouk E, Lefrançois P, Litvinov IV. Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review. Int J Mol Sci 2023;24:ijms24054989. [PMID: 36902419 PMCID: PMC10003023 DOI: 10.3390/ijms24054989] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open

Salman S, Sarsik SM, El-Qushayri AE, Sakr S, Ghozy S, Salem ML. Safety and efficacy of the combination of cryotherapy and photodynamic modalities with imiquimod in patients with actinic keratosis: a systematic review and meta-analysis. Ital J Dermatol Venerol 2023;158:15-20. [PMID: 36799007 DOI: 10.23736/s2784-8671.22.07461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]

Sgouros D, Milia-Argyti A, Arvanitis DK, Polychronaki E, Kousta F, Panagiotopoulos A, Theotokoglou S, Syrmali A, Theodoropoulos K, Stratigos A, Rigopoulos D, Katoulis A. Actinic Keratoses (AK): An Exploratory Questionnaire-Based Study of Patients’ Illness Perceptions. Curr Oncol 2022;29:5150-5163. [PMID: 35877268 PMCID: PMC9323725 DOI: 10.3390/curroncol29070408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open

Abstract

Simple Summary

We recorded 208 patients receiving treatment for AK and conducted a cross-sectional questionnaire-based study, which aimed to investigate patients’ perceptions of their illness. Our main objective was the detection not only of the illness perception of AK patients, but also of its influence on their perception of treatment and the correlation with patients’ demographic characteristics and history, as well as the readiness to use sunscreen. The rising incidence of AK and its socioeconomic burden place the illness perception of AK patients among the most important barriers to overcome for the effective management of the disease. To the best of our knowledge, this is one of the first studies to attempt to unveil the illness perceptions of AK patients and their correlation with patients’ demographics and sunscreen use and the influence on AK treatment. We strongly support reinforcing the awareness of AK and the role of dermatologists is crucial for this direction.

Abstract

Background: Decreased illness perception among actinic keratoses (AK) patients is a major barrier to the effective management of AK. Objective: We aimed to investigate patients’ illness and treatment perceptions, their correlation to demographics and AK/skin cancer history, and secondarily the influence of these perspectives on treatment and sunscreen use. Materials and Methods: Participants completed questionnaires based on the Brief Illness Perception Questionnaire and statistical analysis was performed. Results: In total, 208 AK patients were enrolled. A large proportion were poorly aware of the disease (41.4%), with less than half (43%) being familiar with AK. Patients were aware of the chronic nature of the disease and its correlation to sunlight regardless of demographic characteristics. The level of education played a role in disease awareness (p = 0.006), and treatment plan perception (p = 0.002). The increase in sunscreen protection after AK diagnosis was higher in women (p = 0.009) and younger patients (p = 0.044). Patients’ concerns regarding treatment were mainly related to the duration (30%) and effectivity (25%). Dermatologists’ statements highlighting that AK are precancerous lesions (86.2%) influenced patients’ willingness for treatment. Conclusion: Improved awareness of AK is necessary to increase treatment seeking and compliance, regarding both treatment and sunscreen use. Dermatologists’ statements may have critical influence on patients’ decisions to receive treatment for AK.

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Affiliation(s)

Dimitrios Sgouros 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (S.T.); (A.S.); (K.T.); (A.K.) Correspondence: or ; Tel.: +30-69-74816025 or +30-21-0583-2396; Fax: +30-21-0583-2396
Adamantia Milia-Argyti 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (A.M.-A.); (E.P.); (F.K.); (A.P.); (A.S.); (D.R.)
Dimitrios K. Arvanitis 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (S.T.); (A.S.); (K.T.); (A.K.)
Eleni Polychronaki 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (A.M.-A.); (E.P.); (F.K.); (A.P.); (A.S.); (D.R.)
Fiori Kousta 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (A.M.-A.); (E.P.); (F.K.); (A.P.); (A.S.); (D.R.)
Antonios Panagiotopoulos 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (A.M.-A.); (E.P.); (F.K.); (A.P.); (A.S.); (D.R.)
Sofia Theotokoglou 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (S.T.); (A.S.); (K.T.); (A.K.)
Anna Syrmali 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (S.T.); (A.S.); (K.T.); (A.K.)
Konstantinos Theodoropoulos 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (S.T.); (A.S.); (K.T.); (A.K.)
Alexander Stratigos 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (A.M.-A.); (E.P.); (F.K.); (A.P.); (A.S.); (D.R.)
Dimitrios Rigopoulos 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece; (A.M.-A.); (E.P.); (F.K.); (A.P.); (A.S.); (D.R.)
Alexander Katoulis 2nd Department of Dermatology-Venereology, “Attikon” General University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (D.K.A.); (S.T.); (A.S.); (K.T.); (A.K.)

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Cabral AMTDPV, Fernandes ACG, Joaquim NAM, Veiga F, Sofio SPC, Paiva I, Esteso MA, Rodrigo MM, Valente AJM, Ribeiro ACF. Complexation of 5-Fluorouracil with β-Cyclodextrin and Sodium Dodecyl Sulfate: A Useful Tool for Encapsulating and Removing This Polluting Drug. TOXICS 2022;10:toxics10060300. [PMID: 35736908 PMCID: PMC9228719 DOI: 10.3390/toxics10060300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023]

Kim Y, Yin J, Huang H, Jorgenson E, Choquet H, Asgari MM. Genome-wide association study of actinic keratosis identifies new susceptibility loci implicated in pigmentation and immune regulation pathways. Commun Biol 2022;5:386. [PMID: 35449187 PMCID: PMC9023580 DOI: 10.1038/s42003-022-03301-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 03/18/2022] [Indexed: 01/07/2023] Open

Efficacy and safety of a thermal fractional skin rejuvenation system (Tixel) for the treatment of facial and/or scalp actinic keratoses. Lasers Med Sci 2022;37:2899-2905. [PMID: 35412157 DOI: 10.1007/s10103-022-03558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/01/2022] [Indexed: 10/18/2022]

Heppt MV, Dykukha I, Graziadio S, Salido-Vallejo R, Chapman-Rounds M, Edwards M. Comparative Efficacy and Safety of Tirbanibulin for Actinic Keratosis of the Face and Scalp in Europe: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. J Clin Med 2022;11:1654. [PMID: 35329979 PMCID: PMC8952421 DOI: 10.3390/jcm11061654] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 01/08/2023] Open

Arisi M, Guasco Pisani E, Calzavara-Pinton P, Zane C. Cryotherapy for Actinic Keratosis: Basic Principles and Literature Review. Clin Cosmet Investig Dermatol 2022;15:357-365. [PMID: 35283641 PMCID: PMC8906699 DOI: 10.2147/ccid.s267190] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/22/2022] [Indexed: 11/25/2022]

Hu C, Liu X, Wang P, Guo L, Li C, Xu M, Zhang G, Wang X. Dermoscopy and ultrosound monitoring actinic keratosis with cutaneous squamous cell carcinoma: A case report and literature review. Photodiagnosis Photodyn Ther 2021;37:102709. [PMID: 34973428 DOI: 10.1016/j.pdpdt.2021.102709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/07/2021] [Accepted: 12/28/2021] [Indexed: 10/19/2022]

Mehta NK, Nguyen SA, Chang BA, Nathan CA. Trend Analysis of Cutaneous Squamous Cell Carcinoma of the External Lip From 1975 to 2016. JAMA Otolaryngol Head Neck Surg 2021;147:624-631. [PMID: 33983364 DOI: 10.1001/jamaoto.2021.0760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]

Abstract

Importance

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer and commonly affects the head and neck. Increasing regional reports of aggressive cases warrant an analysis of population-based trends of cSCC of the head and neck.

Objective

To assess demographic, clinical, and survival trends among patients with cSCC of the external lip.

Design, Setting, and Participants

This was a retrospective, population-based cohort study of 15 171 cases of cSCC of the external lip registered in the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. Statistical analyses were conducted in October 2020.

Main Outcomes and Measures

The primary outcome was clinical characteristics (tumor site, stage, and tumor grade). Demographic characteristics, incidence, treatment characteristics, and survival outcomes were also assessed.

Results

In total, 15 171 cases of cSCC were extracted from the SEER database (80.3% of patients were male, and 97.0% identified as being of White race/ethnicity). Incidence among male patients decreased from 4.4 to 0.8 per 100 000 during the study period, whereas the female patients' share cases increased from 8.4% in 1975 to 1979 to 26.1% by 2016. Cases increased in the US Pacific Coast and eastern regions, and along the 30° to 39° N latitudinal range, while decreasing in the southwestern region. Of 15 171 cases, 51.2% cases presented at stage I, and 96.2% were nonmetastatic. Cases of grade II and grade III tumors increased between 1975 and 2016. Five-year disease-specific survival remained stable at 95.9%; however, patients older than 75 years experienced worse disease-specific survival (93.2%) associated with decreasing survival trends among patients older than 85 years.

Conclusion and Relevance

This population-based cohort study found that incidence of cSCC of the external lip decreased among men; however, cases increased along US coastal regions and in more northern US latitudes. Tumor grades were increasingly advanced, and patients older than 85 years should be given special prognosis and treatment consideration.

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Philipp-Dormston WG, Aschoff R, von Braunmühl T, Eigentler T, Haalck T, Thoms KM. [Decision criteria and patient characteristics for patient-oriented treatment of field cancerization : Standardized algorithm for personalized treatment concepts]. Hautarzt 2021;72:314-320. [PMID: 33263779 PMCID: PMC8016782 DOI: 10.1007/s00105-020-04731-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]

Ewert de Oliveira B, Junqueira Amorim OH, Lima LL, Rezende RA, Mestnik NC, Bagatin E, Leonardi GR. 5-Fluorouracil, innovative drug delivery systems to enhance bioavailability for topical use. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.102155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]

Moscarella E, Di Brizzi EV, Casari A, De Giorgi V, Di Meo N, Fargnoli MC, Lacarrubba F, Micali G, Pellacani G, Peris K, Piaserico S, Calzavara-Pinton P, Quaglino P, Sollena P, Zalaudek I, Zane C, Argenziano G. Italian expert consensus paper on the management of patients with actinic keratoses. Dermatol Ther 2020;33:e13992. [PMID: 32648324 DOI: 10.1111/dth.13992] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/25/2020] [Accepted: 07/07/2020] [Indexed: 01/15/2023]

SmartPDT®: Smartphone enabled real-time dosimetry via satellite observation for daylight photodynamic therapy. Photodiagnosis Photodyn Ther 2020;31:101914. [PMID: 32645436 PMCID: PMC7336930 DOI: 10.1016/j.pdpdt.2020.101914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 02/01/2023]

Pereyra-Rodriguez J, Monserrat-García M, Corbí-Llopis R, Conejo-Mir Sánchez J. Determinantes del tratamiento de las queratosis actínicas por médicos de atención primaria. ACTAS DERMO-SIFILIOGRAFICAS 2020;111:444-446. [DOI: 10.1016/j.ad.2018.10.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 11/26/2022] Open

Pereyra-Rodriguez J, Monserrat-García M, Corbí-Llopis R, Conejo-Mir Sánchez J. Actinic Keratosis and Primary Care Physicians: Factors Affecting the Decision to Treat or Not. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2018.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open

Guorgis G, Anderson CD, Lyth J, Falk M. Actinic Keratosis Diagnosis and Increased Risk of Developing Skin Cancer: A 10-year Cohort Study of 17,651 Patients in Sweden. Acta Derm Venereol 2020;100:adv00128. [PMID: 32314794 PMCID: PMC9128984 DOI: 10.2340/00015555-3486] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 11/16/2022] Open

Platsidaki E, Kostopoulos N, Panagakis P, Cheliotis G, Antoniou C, Kontochristopoulos G. The use of ingenol mebutate to treat actinic keratosis in standard clinical practice: a prospective phase IV multicenter observational cohort study. Int J Dermatol 2020;59:690-697. [DOI: 10.1111/ijd.14879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/15/2020] [Accepted: 03/21/2020] [Indexed: 11/28/2022]

Cramer P, Stockfleth E. Actinic keratosis: where do we stand and where is the future going to take us? Expert Opin Emerg Drugs 2020;25:49-58. [PMID: 32067498 DOI: 10.1080/14728214.2020.1730810] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]

Dianzani C, Conforti C, Giuffrida R, Corneli P, di Meo N, Farinazzo E, Moret A, Magaton Rizzi G, Zalaudek I. Current therapies for actinic keratosis. Int J Dermatol 2020;59:677-684. [PMID: 32012240 DOI: 10.1111/ijd.14767] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 12/31/2019] [Accepted: 12/31/2019] [Indexed: 12/15/2022]

Velter C. Épidémiologie des kératoses actiniques. Ann Dermatol Venereol 2019;146 Suppl 2:IIS3-IIS9. [PMID: 31133227 DOI: 10.1016/s0151-9638(19)30199-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]

Foley K, Gupta AK, Martin G, Tweed JA, Villanueva E, Carviel J. Topical treatments and photodynamic therapy for actinic keratosis of the face and scalp. Hippokratia 2019. [DOI: 10.1002/14651858.cd013452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]

von Dobbeler C, Schmitz L, Dicke K, Szeimies R, Dirschka T. PDT with PPIX absorption peaks adjusted wavelengths: Safety and efficacy of a new irradiation procedure for actinic keratoses on the head. Photodiagnosis Photodyn Ther 2019;27:198-202. [DOI: 10.1016/j.pdpdt.2019.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 02/06/2023]

Schmitz L, Hansen JB, Bastian M, Larsson T, Stockfleth E. Treatment responder analysis in actinic keratosis: can it lead the way to individualized choice of treatment? J DERMATOL TREAT 2019;32:411-417. [PMID: 31469026 DOI: 10.1080/09546634.2019.1662879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]

de Berker D, Pasch MC. Primary care and actinic keratosis. Br J Dermatol 2019;181:13-14. [PMID: 31259407 DOI: 10.1111/bjd.18102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]

Misitzis A, Beatson M, Weinstock MA. A study on healthcare utilization for actinic keratoses in the Netherlands highlights a global issue. Br J Dermatol 2019;181:441-442. [PMID: 31250917 DOI: 10.1111/bjd.17862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]

Treatment of actinic cheilitis: a systematic review. Clin Oral Investig 2019;23:2041-2053. [DOI: 10.1007/s00784-019-02895-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 04/03/2019] [Indexed: 12/24/2022]

Noels EC, Hollestein LM, van Egmond S, Lugtenberg M, van Nistelrooij LPJ, Bindels PJE, van der Lei J, Stern RS, Nijsten T, Wakkee M. Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis. Br J Dermatol 2019;181:544-553. [PMID: 30636037 PMCID: PMC6850060 DOI: 10.1111/bjd.17632] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2019] [Indexed: 12/25/2022]

Abstract

Background

The high prevalence of actinic keratosis (AK) requires the optimal use of healthcare resources.

Objectives

To gain insight in to the healthcare utilization of people with AK in a population‐based cohort, and the management of AK in a primary and secondary care setting.

Methods

A retrospective cohort study using three complementary data sources was conducted to describe the use of care, diagnosis, treatment and follow‐up of patients with AK in the Netherlands. Data sources consisted of a population‐based cohort study (Rotterdam Study), routine general practitioner (GP) records (Integrated Primary Care Information) and nationwide claims data (DRG Information System).

Results

In the population‐based cohort (Rotterdam Study), 69% (918 of 1322) of participants diagnosed with AK during a skin‐screening visit had no previous AK‐related visit in their GP record. This proportion was 50% for participants with extensive AK (i.e. ≥ 10 AKs; n = 270). Cryotherapy was the most used AK treatment by both GPs (78%) and dermatologists (41–56%). Topical agents were the second most used treatment by dermatologists (13–21%) but were rarely applied in primary care (2%). During the first AK‐related GP visit, 31% (171 of 554) were referred to a dermatologist, and the likelihood of being referred was comparable between low‐ and high‐risk patients, which is inconsistent with the Dutch general practitioner guidelines for ‘suspicious skin lesions’ from 2017. Annually, 40 000 new claims representing 13% of all dermatology claims were labelled as cutaneous premalignancy. Extensive follow‐up rates (56%) in secondary care were registered, while only 18% received a claim for a subsequent cutaneous malignancy in 5 years.

Conclusions

AK management seems to diverge from guidelines in both primary and secondary care. Underutilization of field treatments, inappropriate treatments and high referral rates without proper risk stratification in primary care, combined with extensive follow‐up in secondary care result in the inefficient use of healthcare resources and overburdening in secondary care. Efforts directed to better risk differentiation and guideline adherence may prove useful in increasing the efficiency in AK management.

What's already known about this topic?

The prevalence of actinic keratosis (AK) is high and, in particular, multiple AKs are a strong skin cancer predictor.

The high prevalence of AK requires optimal use of healthcare resources.

Nevertheless, (population based) AK healthcare utilization and management data are very rare.

What does this study add?

Although AK‐related care already consumes substantial resources, about 70% of the AK population has never received care.

Primary care AK management demonstrated underutilization of topical therapies and high referral rates without proper risk stratification, while in secondary care the extensive follow‐up schedules were applied.

This inefficient use of healthcare resources highlights the need for better harmonization and risk stratification to increase the efficiency of AK care.

Linked Comment: https://doi.org/10.1111/bjd.17862.

https://doi.org/10.1111/bjd.18269 available online

https://www.bjdonline.com/article/

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Spyridonos P, Gaitanis G, Likas A, Bassukas ID. Late fusion of deep and shallow features to improve discrimination of actinic keratosis from normal skin using clinical photography. Skin Res Technol 2019;25:538-543. [PMID: 30762255 DOI: 10.1111/srt.12684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/17/2018] [Accepted: 01/12/2019] [Indexed: 11/29/2022]

Bobyr I, Campanati A, Giacchetti A, Offidani A. Fluorescent photodiagnostic evaluation of field cancerization treated with a medical device containing piroxicam 0.8% and sunscreen SPF 50+ for actinic keratosis. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019;35:277-279. [PMID: 30690758 DOI: 10.1111/phpp.12452] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/18/2019] [Indexed: 11/29/2022]

Calzavara-Pinton P, Zane C, Arisi M, Hamon PA, Tanova NT. Evaluation of the costs of topical treatments for actinic keratosis based on lesion response and the affected area. GIORN ITAL DERMAT V 2018;153:764-775. [DOI: 10.23736/s0392-0488.18.06071-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]

Skroza N, Bernardini N, Proietti I, Potenza C. Clinical utility of ingenol mebutate in the management of actinic keratosis: perspectives from clinical practice. Ther Clin Risk Manag 2018;14:1879-1885. [PMID: 30323610 PMCID: PMC6174892 DOI: 10.2147/tcrm.s145779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open

Abstract

Actinic keratoses (AKs) are epidermal cutaneous neoplasia observed predominantly in middle-aged and older subjects with mainly photo type I and photo type II on sun-exposed surfaces as a result of DNA damage. AKs have historically been characterized as being "precancerous"; however, now it is considered by many authors a carcinoma in situ that can persist or progress to invasive squamous cell carcinoma (SCC) with metastatic potential. Despite the advances in the recognition of typical clinic, dermoscopic and histologic patterns, currently it is not yet possible to predict which AKs will progress to SCC. For this reason, early diagnosis and effective therapy are recommended based on cost/risk/benefit analysis. Current treatment consists of lesion-directed or field-directed therapies or a combination of both. Among the topical field therapies, ingenol mebutate stands out for its therapeutic efficacy, both as directed lesion therapy and as field directed therapy. The aim of this review is to demonstrate the utility of ingenol mebutate in the management of AK in daily clinical practice and to highlight data from real world in order to confirm evidence from pivotal studies. In order to explore clinical data from real world, PubMed searches were performed with the search terms "clinical data ingenol mebutate" and "real world ingenol mebutate". The hits were examined for relevant articles using defaults criteria. The timeframe for the sample search started from the first publication on this topic in 2008 up to now. A total of 23 articles were found using the keywords specified above. The overview points out a low number of real-life studies on the effectiveness and tolerability of this novel treatment due to short period of clinical experience for its recent approval. Further real-life studies are required in order to better identify the efficacy, safety and adherence of the drug on a larger population.

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Bobyr I, Campanati A, Offidani A. "SENECA" Sinecatechins 10% ointment: A green tea extract for the treatment of actinic keratosis. Case series. Dermatol Ther 2018;31:e12634. [PMID: 30175472 DOI: 10.1111/dth.12634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 03/22/2018] [Accepted: 06/02/2018] [Indexed: 11/27/2022]

Stockfleth E, Bastian M. Pharmacokinetic and pharmacodynamic evaluation of ingenol mebutate for the treatment of actinic keratosis. Expert Opin Drug Metab Toxicol 2018;14:911-918. [DOI: 10.1080/17425255.2018.1508449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]

de Oliveira ECV, da Motta VRV, Pantoja PC, Ilha CSDO, Magalhães RF, Galadari H, Leonardi GR. Actinic keratosis - review for clinical practice. Int J Dermatol 2018;58:400-407. [PMID: 30070357 DOI: 10.1111/ijd.14147] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 06/17/2018] [Accepted: 06/20/2018] [Indexed: 12/18/2022]

A Single-Arm, Open-Label, Phase IV Study to Evaluate the Efficacy of a Topical Formulation for Hyperkeratotic Actinic Keratosis Lesions. Dermatol Ther (Heidelb) 2018;8:455-462. [PMID: 30054800 PMCID: PMC6109024 DOI: 10.1007/s13555-018-0252-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Indexed: 01/03/2023] Open

Demay SDJ, Sharma K, Sapra S, Sapra R, Sapra P. Daylight-Mediated Photodynamic Therapy With Methyl Aminolevulinate in Actinic Keratosis Treatment. J Cutan Med Surg 2018;22:267-272. [PMID: 29351725 DOI: 10.1177/1203475417752367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]

Ferrándiz-Pulido C, Lera-Imbuluzqueta M, Ferrándiz C, Plazas-Fernandez M. Prevalence of Actinic Keratosis in Different Regions of Spain: The EPIQA Study. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2017.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open

Schmitz L, Gambichler T, Gupta G, Stücker M, Dirschka T. Actinic keratosis area and severity index (AKASI) is associated with the incidence of squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017;32:752-756. [DOI: 10.1111/jdv.14682] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/17/2017] [Indexed: 12/14/2022]

Ulrich M, Reinhold U, Falqués M, Rodriguez Azeredo R, Stockfleth E. Use of reflectance confocal microscopy to evaluate 5-fluorouracil 0.5%/salicylic acid 10% in the field-directed treatment of subclinical lesions of actinic keratosis: subanalysis of a Phase III, randomized, double-blind, vehicle-controlled trial. J Eur Acad Dermatol Venereol 2017;32:390-396. [DOI: 10.1111/jdv.14611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 09/19/2017] [Indexed: 11/27/2022]

Ferrándiz-Pulido C, Lera-Imbuluzqueta M, Ferrándiz C, Plazas-Fernandez MJ. Prevalence of Actinic Keratosis in Different Regions of Spain: The EPIQA Study. ACTAS DERMO-SIFILIOGRAFICAS 2017;109:83-86. [PMID: 29025692 DOI: 10.1016/j.ad.2017.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/03/2017] [Accepted: 05/07/2017] [Indexed: 11/26/2022] Open

Cerio R. The importance of patient-centred care to overcome barriers in the management of actinic keratosis. J Eur Acad Dermatol Venereol 2017;31 Suppl 2:17-20. [PMID: 28263022 DOI: 10.1111/jdv.14091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 12/14/2016] [Indexed: 12/29/2022]

Abstract

Visible actinic keratosis (AK) lesions and subclinical (non-visible) sun damage in the field of cancerization are associated with risk of both non-melanoma skin cancer, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), and, more rarely, melanoma. As the incidences of AK and skin cancer are increasing, effective prevention and treatment of AK is essential to minimize disease burden and improve patient quality of life. Currently, AK lesions are often left untreated and field therapies are underused. Patient-centred care, with a focus on the patient-physician relationship, has proven cost-effective, and improved clinical outcomes and patient satisfaction in a number of therapy areas. Strategies for applying patient-centred care to AK are warranted. Existing barriers to the effective treatment of AK were identified and patient-centric strategies to overcome each barrier were discussed. Barriers to effective AK treatment include poor disease awareness (for both patient and physician), concerns associated with the cosmetic effects of treatment, treatment-related side effects, cost perceptions for lesion-directed vs field-directed therapies, and inadequate adherence, particularly with long treatment duration. Overcoming these barriers will involve patient and physician education that promotes: disease prevention and awareness; the importance of self-examination; an understanding of treatment options; and the importance of adherence to treatment. To maximize its effectiveness, education should be delivered within a patient-centric framework, where the relationship between patient and physician is built on effective communication, empathy and a feeling of partnership. Patient-centric care, including patient education, is key to overcoming the barriers associated with effective AK treatment.

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de Berker D, McGregor JM, Mohd Mustapa MF, Exton LS, Hughes BR. British Association of Dermatologists' guidelines for the care of patients with actinic keratosis 2017. Br J Dermatol 2017;176:20-43. [PMID: 28098380 DOI: 10.1111/bjd.15107] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2016] [Indexed: 01/06/2023]