| Pharmacotherapy of actinic keratosis: an update. | |
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MedLine Citation:
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PMID: 22888917 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Actinic keratosis (AK) represents the initial intraepidermal manifestation of abnormal keratinocyte proliferation, with the potential of progression to squamous cell carcinoma (SCC). Few visible AKs lead to the use of lesion-directed treatments, including ablative and/or surgical procedures. Multiple and/or the suspicion of subclinical (non-visible) AKs lead to the use of field-directed therapies, including topical and ablative treatments. Predicting which AK will progress to SCC is difficult, and so all are treated. The goals of treatment are to eliminate visible AKs and to treat subclinical (non-visible) AKs, minimizing their risk of progression to invasive SCC, while pursuing good cosmesis. AREAS COVERED: This review discusses the prevention of AKs (such as ultraviolet light avoidance, sunscreen use, protective clothing, and frequent self-examinations, in addition to chemoprevention with retinoids, eflornithine, silymarin, and others). It also covers lesion-directed treatments (e.g., cryotherapy, electrodessication and curettage, and surgery). Field-directed treatments are also mentioned (including laser resurfacing, dermabrasion, chemical peels, topical immunomodulators (imiquimod and diclofenac), topical chemotherapeutic agents (5-fluorouracil and retinoids), and photodynamic therapy). Finally, newer and investigational treatments are discussed (including ingenol mebutate). EXPERT OPINION: There is no panacea in the treatment of AKs. The current best approach is the sequential treatment with a lesion-directed and a field-directed therapy. Several combinations seem to work well; they just need to be selected based on the evidence and adjusted to patient needs, preferences and dermatologist expertise. |
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Authors:
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Brian Berman; Sadegh Amini |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Expert opinion on pharmacotherapy Volume: 13 ISSN: 1744-7666 ISO Abbreviation: Expert Opin Pharmacother Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-08-14 Completed Date: 2013-01-07 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 100897346 Medline TA: Expert Opin Pharmacother Country: England |
Other Details:
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Languages: eng Pagination: 1847-71 Citation Subset: IM |
Affiliation:
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Center for Clinical and Cosmetic Research, Skin and Cancer Associates, Aventura, FL 33180, USA. bbmdphd@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Carcinoma, Squamous Cell / etiology, prevention & control* Cell Proliferation Disease Progression Humans Keratinocytes / pathology Keratosis, Actinic / complications, prevention & control, therapy* Photochemotherapy / methods Skin Neoplasms / etiology, prevention & control* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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