Section of Dermatology II, University of Florence, Local Health Unit 10, Florence, Italy.
G Ital Dermatol Venereol. 2009 Dec;144(6):713-23.
The prevalence of actinic keratosis (AK) continues to rise among white people throughout the world and it is necessary to increase the level of attention paid to it from a diagnostic and a preventive point of view. Today, AK must be considered an in situ squamous cell carcinoma and as such, must be managed using one of the available approved therapeutic alternatives. However, when multiple AKs develop on severely photodamaged skin, the treatment of the lesion together with that of the field of cancerization is part of an optimal strategy that aims not only to solve alterations clinically evident but also those in the surrounding skin field cancerization, that most likely hosts genetic alterations and is the site of initial gradual replacement of normal cells with tumoral cells. This paper reports the most recent evidences from a careful review of the literature's key articles of the treatment of AKs and suggests guidelines for the clinicians. The guidelines indicated by the authors have also been based on practical evaluations and their own clinical experience. The present conclusions may be modified by new findings in the field of oncologic research.
光化性角化病（AK）在世界各地的白人中患病率持续上升，有必要从诊断和预防的角度提高对其的重视程度。如今，AK 必须被视为原位鳞状细胞癌，因此，必须使用现有的一种经批准的治疗方法进行治疗。然而，当大量 AK 出现在严重光损伤的皮肤上时，对病变的治疗以及对癌化区域的治疗是最佳策略的一部分，该策略的目的不仅是解决临床可见的改变，还要解决周围皮肤癌化区域的改变，因为后者很可能存在遗传改变，并且是最初逐渐用肿瘤细胞替代正常细胞的部位。本文报告了对 AK 治疗的关键文献的仔细审查的最新证据，并为临床医生提出了指导方针。作者提出的指南也是基于实际评估和他们自己的临床经验。新的肿瘤学研究领域的发现可能会修改目前的结论。
