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American Journal of Clinical Dermatology
Published in: American Journal of Clinical Dermatology 4/2018

01-08-2018 | Review Article

Field Cancerization Therapies for Management of Actinic Keratosis: A Narrative Review

Authors: Nathan Jetter, Neha Chandan, Stephanie Wang, Maria Tsoukas

Published in: American Journal of Clinical Dermatology | Issue 4/2018

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Abstract

Actinic keratoses (AKs) are atypical, precancerous proliferations of keratinocytes that develop because of chronic exposure to ultraviolet (UV) radiation. Treatment of AK can be lesion-directed or field-directed. Field cancerization theory postulates that the skin surrounding AK is also at increased risk for possible malignant transformation since it has been exposed to the same chronic UV light. Field-directed therapies thus have the potential to address subclinical damage, reduce AK recurrence rates, and potentially reduce the risk of squamous cell carcinoma (SCC) development. Published clinical studies have found lesion clearance rates ranging from 81 to 91% for photodynamic therapy (PDT) with either aminolevulinic acid (ALA) or methylaminolevulinate (MAL). Clinical studies have also been published on various topical treatments. Complete clinical clearance (CCC) was significantly higher in patients treated with a combination of 5-fluorouracil and salicylic acid (5-FU–SA) than in the vehicle group across multiple studies, and CCC ranged between 46 and 48% following treatment with imiquimod. Additionally, treatment with diclofenac sodium (DFS) found reduction in lesion sizes to range from 67 to 75%. Reported results have been similar for another non-steroidal anti-inflammatory drug (NSAID), piroxicam, which has more cyclooxygenase (COX)-1 activity than DFS. Active treatments with ingenol mebutate were also significantly more effective than vehicle at clearing AK lesions. All treatments resulted in mild, localized skin reactions. PDT using conventional light sources was associated with increased severity of pain and/or discomfort, while PDT using daylight as the light source was associated with less pain and occasionally no pain at all. Though no widely accepted algorithm for the treatment of AKs exists, field-directed therapy can be particularly useful for treating photo-exposed areas containing multiple AKs. Additional research with more direct comparisons between these field-directed therapies will help clinicians determine the best therapeutic approach. Here, we provide a balanced and comprehensive narrative review of the literature, considering both light-based and topical therapies with a focus on their field-therapy aspects, and propose a therapeutic algorithm for selecting an appropriate treatment in the clinical setting.
Literature
1.
Siegel JA, Korgavkar K, Weinstock MA. Current perspective on actinic keratosis: a review. Br J Dermatol. 2017;177:350–8.CrossRefPubMed
2.
Marks R, Jolley D, Dorevitch AP, Selwood TS. The incidence of non-melanocytic skin cancers in an Australian population: results of a five-year prospective study. Med J Aust. 1989;150:475–8.PubMed
3.
Calzavara-Pinton P, Venturini M, Sala R. Photodynamic therapy: update 2006. Part 2: Clinical results. J Eur Acad Dermatol Venereol. 2006;2007(21):439–51.
4.
Dodds A, Chia A, Shumack S. Actinic keratosis: rationale and management. Dermatol Ther (Heidelb). 2014;4:11–31.CrossRef
5.
Dougherty TJ, Kaufman JE, Goldfarb A, Weishaupt KR, Boyle D, Mittleman A. Photoradiation therapy for the treatment of malignant tumors. Cancer Res. 1978;38(8):2628–35.PubMed
6.
Kennedy JC, Pottier RH. Endogenous protoporphyrin IX, a clinically useful photosensitizer for photodynamic therapy. J Photochem Photobiol B. 1992;14(4):27592.CrossRef
7.
Brancaleon L, Moseley H. Laser and non-laser light sources for photodynamic therapy. Lasers Med Sci. 2002;17:173–86.CrossRefPubMed
8.
Babilas P, Landthaler M, Szeimies R. Photodynamic therapy in dermatology. Eur J Dermatol. 2006;16:340.PubMed
9.
Juzeniene A. Photodynamic therapy at the cellular level: the principles of 5-aminolevulinic acid photodynamic therapy. Trivandrum: Research Signpost; 2007. p. 115–40.
10.
Jeffes E. Levulan: the first approved topical photosensitizer for the treatment of actinic keratosis. J Dermatol Treat. 2002;13:s23.CrossRef
11.
Kelty CJ, Brown NJ, Reed MWR, Ackroyd R. The use of 5-aminolaevulinic acid as a photosensitiser in photodynamic therapy and photodiagnosis. Photochem Photobiol Sci. 2002;1:158–68.CrossRefPubMed
12.
Reinhold U, Dirschka T, Ostendorf R, Aschoff R, Berking C, Philipp-Dormston WG, et al. A randomized, double-blind, phase III, multicentre study to evaluate the safety and efficacy of BF-200 ALA (Ameluz®) vs. placebo in the field-directed treatment of mild-to-moderate actinic keratosis with photodynamic therapy (PDT) when using the BF-RhodoLED® lamp. Br J Dermatol. 2016;175:696–705.CrossRefPubMed
13.
Center for Drug Evaluation and Research. Approval package for application number: 208081Orig1s000. 5 October 2016.
14.
Jeffes EW, McCullough JL, Weinstein GD, Kaplan R, Glazer SD, Taylor JR. Photodynamic therapy of actinic keratoses with topical aminolevulinic acid hydrochloride and fluorescent blue light. J Am Acad Dermatol. 2001;45:96–104.CrossRefPubMed
15.
Piacquadio DF, Chen DM, Farber HF, Fowler JF, Glazer SD, Goodman JJ, et al. Photodynamic therapy with aminolevulinic acid topical solution and visible blue light in the treatment of multiple actinic keratoses of the face and scalp: investigator-blinded, phase 3, multicenter trials. Arch Dermatol. 2004;140:41.CrossRefPubMed
16.
Szeimies RM, Radny P, Sebastian M, Borrosch F, Dirschka T, Krahn-Senftleben G, et al. Photodynamic therapy with BF-200 ALA for the treatment of actinic keratosis: results of a prospective, randomized, double-blind, placebo-controlled phase III study. Br J Dermatol. 2010;163:386–94.CrossRefPubMed
17.
Dirschka T, Radny P, Dominicus R, Mensing H, Brüning H, Jenne L, et al. Photodynamic therapy with BF-200 ALA for the treatment of actinic keratosis: results of a multicentre, randomized, observer-blind phase III study in comparison with a registered methyl-5-aminolaevulinate cream and placebo. Br J Dermatol. 2012;166:137–46.CrossRefPubMed
18.
Jerjes W, Hamdoon Z, Abdulkareem AA, Hopper C. Photodynamic therapy in the management of actinic keratosis: Retrospective evaluation of outcome. Photodiagn Photodyn Ther. 2017;17:200–4.CrossRef
19.
Apalla Z, Sotiriou E, Chovarda E, Lefaki I, Devliotou-Panagiotidou D, Ioannides D. Skin cancer: preventive photodynamic therapy in patients with face and scalp cancerization. A randomized placebo-controlled study. Br J Dermatol. 2010;162:171–5.CrossRefPubMed
20.
Wennberg A, Stenquist B, Stockfleth E, Keohane S, Lear JT, Jemec G, et al. Photodynamic therapy with methyl aminolevulinate for prevention of new skin lesions in transplant recipients: a randomized study. Transplantation. 2008;86:423–9.CrossRefPubMed
21.
Wulf HC, Pavel S, Stender I, Ahb Bakker-Wensveen C. Topical photodynamic therapy for prevention of new skin lesions in renal transplant recipients. Acta Derm Venereol. 2006;86:25–8.PubMed
22.
Szeimies RM, Karrer S, Radakovic-Fijan S, Tanew A, Calzavara-Pinton P, Zane C, et al. Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: a prospective, randomized study. J Am Acad Dermatol. 2002;47:258–62.CrossRefPubMed
23.
Zane C, Capezzera R, Sala R, Venturini M, Calzavara-Pinton P. Clinical and echographic analysis of photodynamic therapy using methylaminolevulinate as sensitizer in the treatment of photodamaged facial skin. Lasers Surg Med. 2007;39:203–9.CrossRefPubMed
24.
Fargnoli MC, Piccioni A, Neri L, Tambone S, Pellegrini C, Peris K. Conventional vs. daylight methyl aminolevulinate photodynamic therapy for actinic keratosis of the face and scalp: an intra-patient, prospective, comparison study in Italy. J Eur Acad Dermatol Venereol. 2015;29:1926–32.CrossRefPubMed
25.
Rubel DM, Spelman L, Murrell DF, See JA, Hewitt D, Foley P, et al. Daylight photodynamic therapy with methyl aminolevulinate cream as a convenient, similarly effective, nearly painless alternative to conventional photodynamic therapy in actinic keratosis treatment: a randomized controlled trial. Br J Dermatol. 2014;171:1164–71.CrossRefPubMed
26.
Lacour J, Ulrich C, Gilaberte Y, Von Felbert V, Basset-Seguin N, Dreno B, et al. Daylight photodynamic therapy with methyl aminolevulinate cream is effective and nearly painless in treating actinic keratoses: a randomised, investigator-blinded, controlled, phase III study throughout Europe. J Eur Acad Dermatol Venereol. 2015;29:2342–8.CrossRefPubMed
27.
Sotiriou E, Apalla Z, Vrani F, Lazaridou E, Vakirlis E, Lallas A, et al. Daylight photodynamic therapy vs. Conventional photodynamic therapy as skin cancer preventive treatment in patients with face and scalp cancerization: an intra-individual comparison study. J Eur Acad Dermatol Venereol. 2017;31:1303–7.CrossRefPubMed
28.
Tran DT, Salmon R. Field treatment of facial and scalp actinic keratoses with photodynamic therapy: survey of patient perceptions of treatment satisfaction and outcomes. Australas J Dermatol. 2011;52:195–201.CrossRefPubMed
29.
Tierney EP, Eide MJ, Jacobsen G, Ozog D. Photodynamic therapy for actinic keratoses: survey of patient perceptions of treatment satisfaction and outcomes. J Cos Laser Therapy. 2008;10:81–6.CrossRef
30.
Vanaman Wilson MJ, Jones IT, Wu DC, Goldman MP. A randomized, double-blind, placebo-controlled clinical trial evaluating the role of systemic antihistamine therapy for the reduction of adverse effects associated with topical 5-aminolevulinic acid photodynamic therapy. Lasers Surg Med. 2017;49:738–42.CrossRefPubMed
31.
Tanaka N, Ohata C, Ishii N, Imamura K, Ueda A, Furumura M, et al. Comparative study for the effect of photodynamic therapy, imiquimod immunotherapy and combination of both therapies on 40 lesions of actinic keratosis in Japanese patients. J Dermatol. 2013;40:962–7.CrossRefPubMed
32.
Yazdanyar S, Zarchi K, Jemec GBE. Pain during topical photodynamic therapy—comparing methyl aminolevulinate (Metvix®) to aminolaevulinic acid (Ameluz®); an intra-individual clinical study. Photodiagnosis Photodyn Ther. 2017;20:6–9.CrossRefPubMed
33.
Kasche A, Luderchmidt S, Ring J, Hein R. Photodynamic therapy induces less pain in patients treated with methyl aminolevulinate compared to aminolevulinic acid. J Drugs Dermatol. 2006;5(4):353–6.PubMed
34.
Moloney FJ, Collins P. Randomized, double-blind, prospective study to compare topical 5-aminolaevulinic acid methylester with topical 5-aminolaevulinic acid photodynamic therapy for extensive scalp actinic keratosis. Br J Dermatol. 2007;157:87–91.CrossRefPubMed
35.
Steinbauer JM, Schreml S, Babilas P, Zeman F, Karrer S, Landthaler M, et al. Topical photodynamic therapy with porphyrin precursors-assessment of treatment-associated pain in a retrospective study. Photochem Photobiol Sci. 2009;8:1111–6.CrossRefPubMed
36.
Arits A, Weert VD, Nelemans PJ, Kelleners-Smeets N. Pain during topical photodynamic therapy: uncomfortable and unpredictable. J Eur Acad Dermatol Venereol. 2010;24:1452–7.CrossRefPubMed
37.
Gaál M, Otrosinka S, Baltás E, Ocsai H, Oláh J, Kemény L, et al. Photodynamic therapy of non-melanoma skin cancer with methyl aminolaevulinate is associated with less pain than with aminolaevulinic acid. Acta Derm Venereol. 2012;92:173–5.CrossRefPubMed
38.
Ibbotson SH, Valentine R, Hearn R. Is the pain of topical photodynamic therapy with methyl aminolevulinate any different from that with 5-aminolaevulinic acid? Photodermatol Photoimmunol Photomed. 2012;28:272–3.CrossRefPubMed
39.
Gholam P, Kroehl V, Enk AH. Dermatology life quality index and side effects after topical photodynamic therapy of actinic keratosis. Dermatology. 2013;226:253–9.CrossRefPubMed
40.
Neittaanmäki-Perttu N, Karppinen TT, Grönroos M, Tani TT, Snellman E. Daylight photodynamic therapy for actinic keratoses: a randomized double-blinded nonsponsored prospective study comparing 5-aminolaevulinic acid nanoemulsion (BF-200) with methyl-5-aminolaevulinate. Br J Dermatol. 2014;171:1172–80.CrossRefPubMed
41.
Martin GM. In-office painless aminolevulinic acid photodynamic therapy: a proof of concept study and clinical experience in more than 100 patients. J Clin Aesthetic Dermatol. 2016;9:19.
42.
Clark C, Bryden A, Dawe R, Moseley H, Ferguson J, Ibbotson SH. Topical 5-aminolaevulinic acid photodynamic therapy for cutaneous lesions: outcome and comparison of light sources. Photodermatol Photoimmunol Photomed. 2003;19:134–41.CrossRefPubMed
43.
Braathen LR. Daylight photodynamic therapy in private practice in Switzerland: gain without pain. Acta Derm Venereol. 2012;92:652.CrossRefPubMed
44.
Wiegell SR, Haedersdal M, Philipsen PA, Eriksen P, Enk CD, Wulf HC. Continuous activation of PpIX by daylight is as effective as and less painful than conventional photodynamic therapy for actinic keratoses; a randomized, controlled, single-blinded study. Br J Dermatol. 2008;158:740–6.CrossRefPubMed
45.
Neittaanmäki-Perttu N, Grönroos M, Karppinen T, Snellman E, Rissanen P. Photodynamic therapy for actinic keratoses: a randomized prospective non-sponsored cost-effectiveness study of daylight-mediated treatment compared with light-emitting diode treatment. Acta Derm Venereol. 2016;96:241.CrossRefPubMed
46.
Ibbotson SH, Ferguson J. Ambulatory photodynamic therapy using low irradiance inorganic light-emitting diodes for the treatment of non-melanoma skin cancer: an open study. Photodermatol Photoimmunol Photomed. 2012;28:235–9.CrossRefPubMed
47.
Ang JM, Riaz IB, Kamal MU, Parah G, Zeitouni NC. Photodynamic therapy and pain: a systematic review. Photodiagn Photodyn Ther. 2017;19:308–44.
48.
Paoli J, Halldin C, Ericson MB, Wennberg A. Nerve blocks provide effective pain relief during topical photodynamic therapy for extensive facial actinic keratoses. Clin Exp Dermatol. 2008;33:559–64.CrossRefPubMed
49.
Halldin CB, Paoli J, Sandberg C, Gonzalez H, Wennberg AM. Nerve blocks enable adequate pain relief during topical photodynamic therapy of field cancerization on the forehead and scalp. Br J Dermatol. 2009;160:795–800.CrossRefPubMed
50.
Serra-Guillen C, Hueso L, Nagore E, Vila M, Llombart B, Requena Caballero C, et al. Comparative study between cold air analgesia and supraorbital and supratrochlear nerve block for the management of pain during photodynamic therapy for actinic keratoses of the frontotemporal zone. Br J Dermatol. 2009;161:353–6.CrossRefPubMed
51.
Klein A, Karrer S, Horner C, Werner A, Heinlin J, Zeman F, et al. Comparing cold-air analgesia, systemically administered analgesia and scalp nerve blocks for pain management during photodynamic therapy for actinic keratosis of the scalp presenting as field cancerization: a randomized controlled trial. Br J Dermatol. 2015;173:192–200.CrossRefPubMed
52.
Kirby JS, Delikat A, Leslie D, Miller JJ. Bundled payment models for actinic keratosis management. JAMA Dermatol. 2016;152:789–97.CrossRefPubMed
53.
Wilson E. Cost effectiveness of imiquimod 5% cream compared with methyl aminolevulinate-based photodynamic therapy in the treatment of non-hyperkeratotic, non-hypertrophic actinic (Solar) Keratoses a decision tree model. Pharmacoeconomics. 2010;28:1055–64.CrossRefPubMed
54.
Colombo GL, Chimenti S, Di Matteo S, Fargnoli MC, Frascione P, Silipo V, et al. Cost-effectiveness analysis of topical treatments for actinic keratosis in the perspective of the Italian health care system. Giornale italiano di dermatologia e venereologia : organo ufficiale, Società italiana di dermatologia e sifilografia. 2010;145:573.
55.
Zane C, Facchinetti E, Rossi MT, Specchia C, Calzavara-Pinton PG. A randomized clinical trial of photodynamic therapy with methyl aminolaevulinate vs. diclofenac 3% plus hyaluronic acid gel for the treatment of multiple actinic keratoses of the face and scalp. Br J Dermatol. 2014;170:1143–50.CrossRefPubMed
56.
57.
Vale S, Hill D, Feldman S. Pharmacoeconomic considerations in treating actinic keratosis: an update. Pharmacoeconomics. 2017;35:177–90.CrossRefPubMed
58.
de Berker D, McGregor JM, Hughes BR. Guidelines for the management of actinic keratoses. Br J Dermatol. 2007;156:222–30.CrossRefPubMed
59.
Szeimies R, Dirschka T, Prechtl A, Melzer A. Efficacy of low-dose 5-fluorouracil/salicylic acid in actinic keratoses in relation to treatment duration. JDDG Journal der Deutschen Dermatologischen Gesellschaft. 2015;13:430–8.PubMed
60.
Stockfleth E, von Kiedrowski R, Dominicus R, Ryan J, Ellery A, Falques M, et al. Efficacy and safety of 5-fluorouracil 0.5%/salicylic acid 10% in the field-directed treatment of actinic keratosis: a phase III, randomized, double-blind, vehicle-controlled trial. Dermatol Ther (Heidelb). 2011;7:81–96.CrossRef
61.
Stockfleth E, Kerl H, Zwingers T, Willers C. Low-dose 5-fluorouracil in combination with salicylic acid as a new lesion-directed option to treat topically actinic keratoses: histological and clinical study results. Br J Dermatol. 2011;165:1101–8.CrossRefPubMed
62.
Stockfleth E, Zwingers T, Willers C. Recurrence rates and patient assessed outcomes of 0.5% 5-fluorouracil in combination with salicylic acid treating actinic keratoses. Eur J Dermatol. 2012;22:370–4.PubMed
63.
Berman B, Villa AM, Ramirez CC. Mechanisms of action of new treatment modalities for actinic keratosis. J Drugs Dermatol. 2006;5:167–73.PubMed
64.
Ulrich C, Johannsen A, Röwert-Huber J, Ulrich M, Sterry W, Stockfleth E. Results of a randomized, placebo-controlled safety and efficacy study of topical diclofenac 3% gel in organ transplant patients with multiple actinic keratoses. Eur J Dermatol. 2010;20:482–8.PubMed
65.
Iraji F, Asilian A, Amir HS, Safavai A. Efficacy of 3% diclofenac gel for the treatment of actinic keratoses: a randomized, double-blind, placebo controlled study. Indian J Dermatol Venereol Leprol. 2006;72:346–9.CrossRef
66.
Wolf JE, Taylor JR, Tschen E, Kang S. Topical 3.0% diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses. Int J Dermatol. 2001;40:709–13.CrossRefPubMed
67.
Rivers JK, McLean DI. An open study to assess the efficacy and safety of topical 3% diclofenac in a 2.5% hyaluronic acid gel for the treatment of actinic keratoses. Arch Dermatol. 1997;133:1239–42.CrossRefPubMed
68.
69.
Campione E, Paternò EJ, Candi E, Falconi M, Costanza G, Diluvio L, et al. The relevance of piroxicam for the prevention and treatment of nonmelanoma skin cancer and its precursors. Drug Des Devel Ther. 2015;9:5843–50.CrossRefPubMedPubMedCentral
70.
Campione E, Diluvio L, Paternò EJ, Chimenti S. Topical treatment of actinic keratoses with piroxicam 1% gel: a preliminary open-label study utilizing a new clinical score. Am J Clin Dermatol. 2010;11(1):45–50.CrossRefPubMed
71.
Puviani M, Galloni C, Marchetti S. Efficacy of a film-forming medical device containing sunscreen (50 +) and piroxicam 0.8% in actinic keratosis and field cancerization: a multicenter, assessor-blinded, 3 month trial. Curr Med Res Opin. 2017;33(7):1255–9.CrossRefPubMed
72.
Garofalo C, Ventura A, Mazzilli S. Treatment of multiple actinic keratosis and field of cancerization with topical piroxicam 0.8% and Sunscreen 50 + in organ transplant recipients: a series of 10 cases. Case Rep Dermatol. 2017;9(3):211–6.CrossRefPubMedPubMedCentral
73.
Urosevic M, Maier T, Benninghoff B, Slade H, Burg G, Dummer R. Mechanisms underlying imiquimod-induced regression of basal cell carcinoma in vivo. Arch Dermatol. 2003;139:1325–32.CrossRefPubMed
74.
Khanna R, Bakshi A, Amir Y, Goldenberg G. Patient satisfaction and reported outcomes on the management of actinic keratosis. Clin Cosmet Investig Dermatol. 2017;10:179–84.CrossRefPubMedPubMedCentral
75.
Korman N, Moy R, Ling M. Dosing with 5% imiquimod cream 3 times per week for the treatment of actinic keratosis: results of two phase 3, randomized, double-blind, parallel-group, vehicle-controlled trials. Arch Dermatol. 2005;141:467–73.CrossRefPubMed
76.
Waalboer-Spuij R, Holterhues C, van Hattem S, Schuttelaar MLA, Gaastra MTW, Kuijpers DIM, et al. Patient perception of imiquimod treatment for actinic keratosis and superficial basal cell carcinoma in 202 patients. Dermatology. 2015;231:56–62.CrossRefPubMed
77.
Hanke CW, Beer KR, Stockfleth E, Wu J, Rosen T, Levy S. Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: results of two placebo-controlled studies of daily application to the face and balding scalp for two 3-week cycles. J Am Acad Dermatol. 2010;62:573–81.CrossRefPubMed
78.
Swanson N, Abramovits W, Berman B, Kulp J, Rigel DS, Levy S. Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: results of two placebo-controlled studies of daily application to the face and balding scalp for two 2-week cycles. J Am Acad Dermatol. 2010;62:582–90.CrossRefPubMed
79.
Swanson N, Smith CC, Kaur M, Goldenberg G. Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: two phase 3 multicenter, randomized, double-blind, placebo-controlled studies. J Drugs Dermatol. 2013;12:1278–82.PubMed
80.
Gold MH. Pharmacoeconomic analysis of the treatment of multiple actinic keratoses. J Drugs Dermatol 2008;7(1):23–5.
81.
82.
Garbe C, Basset-Seguin N, Poulin Y, Larsson T, Østerdal ML, Venkata R, et al. Efficacy and safety of follow-up field treatment of actinic keratosis with ingenol mebutate 0.015% gel: a randomized, controlled 12-month study. Br J Dermatol. 2016;174:505–13.CrossRefPubMed
83.
Berman B, Goldenberg G, Hanke CW, Tyring SK, Werschler WP, Knudsen KM, et al. Efficacy and safety of ingenol mebutate 0.015% gel 3 weeks after cryosurgery of actinic keratosis: 11-Week results. Journal of Drugs. Dermatology. 2014;13:154–60.
84.
Anderson L, Schmieder GJ, Werschler WP, Tschen EH, Ling MR, Stough DB, et al. Randomized, double-blind, double-dummy, vehicle-controlled study of ingenol mebutate gel 0.025 and 0.05% for actinic keratosis. J Am Acad Dermatol. 2009;60:934–43.CrossRefPubMed
85.
Schaefer D. Survey of patient satisfaction with ingenol mebutate gel treatment of actinic keratosis from a community dermatology practice. J Am Acad Dermatol. 2015;72:AB193.
86.
Nisticò S, Torchia V, Gliozzi M, Bottoni U, Del Duca E, Muscoli C. Pharmacoeconomy of drugs used in the treatment of actinic keratoses. Int J Immunopathol Pharmacol. 2016;29:796–804.CrossRefPubMedPubMedCentral
87.
Sotiriou E, Apalla Z, Vrani F, Lazaridou E, Vakirlis E, Lallas A, et al. Daylight photodynamic therapy vs. Conventional photodynamic therapy as skin cancer preventive treatment in patients with face and scalp cancerization: an intra-individual comparison study. J Eur Acad Dermatol Venereol. 2017;31:1303–7.CrossRefPubMed
88.
Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med. 1993;329(16):1147–51.CrossRefPubMed
89.
Naylor MF, Boyd A, Smith DW, Cameron GS. High sun protection factor sunscreens in the suppression of actinic neoplasia. Arch Dermatol. 1995;131(2):170–5.CrossRefPubMed
90.
Ulrich C, Jürgensen JS, Degen A. Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case-control study. Br J Dermatol. 2009;161(Suppl 3):78–84.CrossRefPubMed
Metadata
Title
Field Cancerization Therapies for Management of Actinic Keratosis: A Narrative Review
Authors
Nathan Jetter
Neha Chandan
Stephanie Wang
Maria Tsoukas
Publication date
01-08-2018
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 4/2018
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-018-0348-7

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