Cantisani Carmen, De Gado Federico, Ulrich Martina, Bottoni Ugo, Iacobellis Francis, Richetta Antonio G, Calvieri Stefano
Sapienza University of Rome, Italy, Policlinico Umberto I, viale del Policlinico 15500100.
Recent Pat Inflamm Allergy Drug Discov. 2013 May;7(2):168-75. doi: 10.2174/1872213x11307020008.
Actinic Keratoses (AK) are considered a worldwide problem with continuously increasing incidence. They clinically present as rough or scaly plaques and are histologically characterized by a proliferation of atypical keratinocytes limited to the epidermis. AK are considered as an early step in the continuum of transformation from normal skin to invasive squamous cell carcinoma (SCC). These lesions develop on a background of field cancerization in which chronically UV- damaged-areas accumulate molecular changes, but remain clinically normal for prolonged periods. The presence of certain clinical features of AK, such as large size, ulceration, or bleeding, suggests an increased risk of disease progression. The risk is also increased by evidence of extensive solar damage, advanced age, and immune-suppression. Many treatment modalities are available, although recent developments have focused on the management of the whole actinically damaged field. In this regard, several topical drugs have been approved, differing in efficacy, side effects, application and cost. Research continuingly aims to develop the "ideal" treatment which combines high clearance rates with few side effects, short treatment duration and low costs. Herein, we aim to give an overview on current treatment modalities including their mechanism of action, application scheme and common side effects. Furthermore, recent patents in the field and future aspects are discussed in this review.
光化性角化病（AK）被认为是一个全球性问题，其发病率持续上升。它们在临床上表现为粗糙或鳞屑性斑块，组织学特征是限于表皮的非典型角质形成细胞增殖。AK被视为从正常皮肤向浸润性鳞状细胞癌（SCC）转变连续过程中的早期阶段。这些病变在“场癌化”背景下发展，其中长期紫外线损伤区域积累分子变化，但在很长一段时间内临床仍保持正常。AK的某些临床特征，如面积大、溃疡或出血，提示疾病进展风险增加。广泛的日光损伤、高龄和免疫抑制也会增加风险。虽然最近的进展集中在对整个光化损伤区域的管理上，但有多种治疗方式可供选择。在这方面，几种外用药物已获批准，在疗效、副作用、应用和成本方面存在差异。研究不断致力于开发“理想”治疗方法，即结合高清除率、低副作用、短治疗时间和低成本。在此，我们旨在概述当前的治疗方式，包括其作用机制、应用方案和常见副作用。此外，本综述还讨论了该领域的近期专利和未来发展方向。
