Zouboulis C C, Röhrs H
Klinik und Hochschulambulanz für Dermatologie, Campus Benjamin Franklin der Charité-Universitätsmedizin, Berlin.
Hautarzt. 2005 Apr;56(4):353-8. doi: 10.1007/s00105-004-0865-6.
Actinic keratoses are focal epithelial carcinomas in situ, which are considered precursors of squamous cell carcinoma and must therefore be treated. In the USA, cryosurgery is the most frequent surgical procedure for the treatment of actinic keratoses and considered the treatment of choice.
Our own results of cryosurgical treatment of actinic keratoses were evaluated. Original publications and reviews on the treatment of actinic keratoses with cryosurgery were retrieved from MEDLINE and classified according to their evidence level.
Two months after the procedure, 97.0% of the lesions (n=99) were considered sufficiently treated. Local pain during and shortly after treatment (15%) and pigmentary changes (5%) were the most frequent side effects. Recurrences were detected in 2.1% of the lesions during the 1st year and in 11,5% after 3 years. In 2 further monotherapy studies recurrences occurred in 1,2-9% of the lesions after one year in 30% after 3 years. Literature data suggest that photodynamic therapy is equally or even more effective than cryosurgery after a 3-month follow-up. The cryosurgical results were strongly dependent on the attending physician.
Cryosurgery is beneficial in the treatment of actinic keratoses. This method is equivalent to photodynamic therapy.
光化性角化病是局限性原位上皮癌，被认为是鳞状细胞癌的前驱病变，因此必须进行治疗。在美国，冷冻手术是治疗光化性角化病最常用的外科手术，被视为首选治疗方法。
对我们自己采用冷冻手术治疗光化性角化病的结果进行评估。从MEDLINE检索有关冷冻手术治疗光化性角化病的原始出版物和综述，并根据其证据水平进行分类。
术后两个月，97.0%的病变（n = 99）被认为得到充分治疗。治疗期间及治疗后不久的局部疼痛（15%）和色素沉着变化（5%）是最常见的副作用。在第1年，2.1%的病变出现复发，3年后复发率为11.5%。在另外两项单一疗法研究中，1年后1.2 - 9%的病变出现复发，3年后复发率为30%。文献数据表明，经过3个月的随访，光动力疗法与冷冻手术同样有效甚至更有效。冷冻手术的结果很大程度上取决于主治医生。
冷冻手术在治疗光化性角化病方面有益。该方法与光动力疗法等效。
