Dréno Brigitte, Cerio Rino, Dirschka Thomas, Nart Ignasi Figueras, Lear John T, Peris Ketty, de Casas Andrés Ruiz, Kaleci Shaniko, Pellacani Giovanni
Department of Dermato Cancereology, University of Nantes, FR-44093 Nantes, France.
Acta Derm Venereol. 2017 Oct 2;97(9):1108-1113. doi: 10.2340/00015555-2710.
Actinic keratosis (AK) lesions are surrounded by field cancerization (areas of subclinical, non-visible sun damage). Existing AK grading tools rely on AK counts, which are not reproducible. An Actinic Keratosis Field Assessment Scale (AK-FAS) for grading the severity of AK/field was developed. Standardized photographs of patients representing the full range of AK severity were collected. Six investigators independently rated each photograph according to 3 criteria: AK area (total skin area affected by AK lesions), hyperkeratosis and sun damage. Inter-rater reproducibility was good for all 3 criteria. Validation of the AK-FAS showed good reproducibility for AK area and hyperkeratosis, even for dermatologists untrained on use of the scale. In conclusion, the AK-FAS is objective, easy to use and implement, and reproducible. It incorporates assessment of the entire field affected by AK instead of relying on lesion counts. Use of the AK-FAS may standardize AK diagnosis, making it relevant to routine clinical practice.
光化性角化病（AK）皮损被场癌化（亚临床、不可见的日光损伤区域）所包围。现有的AK分级工具依赖于AK计数，而这是不可重复的。一种用于对AK/场的严重程度进行分级的光化性角化病场评估量表（AK-FAS）被开发出来。收集了代表AK严重程度全范围的患者标准化照片。六位研究者根据三个标准独立对每张照片进行评分：AK面积（受AK皮损影响的总皮肤面积）、角化过度和日光损伤。所有三个标准的评分者间再现性良好。AK-FAS的验证表明，即使对于未接受过该量表使用培训的皮肤科医生，AK面积和角化过度的再现性也很好。总之，AK-FAS客观、易于使用和实施，且具有可重复性。它纳入了对受AK影响的整个区域的评估，而不是依赖于皮损计数。AK-FAS的使用可能会使AK诊断标准化，使其与常规临床实践相关。
