Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Bio-Medico University Hospital, Rome, Italy.
Department of Dermatology, Maggiore Hospital, University of Trieste, Trieste, Italy.
Int J Dermatol. 2020 Jun;59(6):677-684. doi: 10.1111/ijd.14767. Epub 2020 Feb 3.
Actinic keratosis (AK) is a very common skin disease caused by chronic sun damage, which in 75% of cases arises on chronically sun-exposed areas, such as face, scalp, neck, hands, and forearms. AKs must be considered an early squamous cell carcinoma (SCC) for their probable progression into invasive SCC. For this reason, all AK should be treated, and clinical follow-up is recommended. The aims of treatment are: (i) to clinically eradicate evident and subclinical lesions, (ii) to prevent their evolution into SCC, and (iii) to reduce the number of relapses. Among available treatments, it is possible to distinguish lesion-directed therapies and field-directed therapies. Lesion-directed treatments include: (i) cryotherapy; (ii) laser therapy; (iii) surgery; and (iv) curettage. Whereas, field-directed treatments are: (i) 5-fluorouracil (5-FU); (ii) diclofenac 3% gel; (iii) chemical peeling; (iv) imiquimod; and (v) photodynamic therapy (PDT). Prevention plays an important role in the treatment of AKs, and it is based on the continuous use of sunscreen and protective clothing. This review shows different types of available treatments and describes the characteristics and benefits of each medication, underlining the best choice.
光化性角化病（AK）是一种由慢性太阳损伤引起的常见皮肤病，在 75%的病例中，这种病发生在长期暴露于太阳的部位，如面部、头皮、颈部、手部和前臂。由于其可能进展为侵袭性鳞状细胞癌（SCC），因此 AK 必须被视为早期 SCC。出于这个原因，所有的 AK 都应该治疗，并建议进行临床随访。治疗的目的是：（i）临床根除明显和亚临床病变，（ii）预防其演变为 SCC，（iii）减少复发次数。在现有的治疗方法中，可以区分病变定向治疗和区域定向治疗。病变定向治疗包括：（i）冷冻疗法；（ii）激光疗法；（iii）手术；和（iv）刮除术。而区域定向治疗是：（i）5-氟尿嘧啶（5-FU）；（ii）双氯芬酸 3%凝胶；（iii）化学换肤；（iv）咪喹莫特；和（v）光动力疗法（PDT）。预防在 AK 的治疗中起着重要作用，它基于防晒霜和防护服的持续使用。本综述展示了不同类型的现有治疗方法，并描述了每种药物的特点和益处，强调了最佳选择。
