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光化性角化病管理的进展与思考:专家共识小组报告。

Advances and Considerations in the Management of Actinic Keratosis: An Expert Consensus Panel Report.

出版信息

J Drugs Dermatol. 2021 Aug 1;20(8):888-893. doi: 10.36849/JDD.6078.

Abstract

BACKGROUND

Actinic Keratosis (AK) is a potentially pre-malignant tumor with a poorly defined risk of progression to invasive squamous cell carcinoma (SCC). Because of the typical need for recurrent cycles of AK treatment, outcomes can be limited by both therapeutic efficacy and patient adherence.

OBJECTIVE

To synthesize the available and most current literature into overarching principles to provide guidance on the management of AKs, improving patient experiences and treatment outcomes.

METHODS

A systematic review querying epidemiology, natural history, prognosis, management of AKs as well as the mechanism of action of and adherence to current AK therapy was conducted. After reviewing the literature, an expert consensus panel consisting of 10 expert dermatologists and dermatopathologists used a modified Delphi process to develop statements regarding the pathogenesis and management of AKs. Final statements were only adopted with a supermajority vote (≥7/10).

RESULTS

The panel developed 7 consensus statements regarding AKs pathogenesis and management.

CONCLUSION

The poorly defined risk for AK progression into invasive SCC without universally accepted clinical-histopathological factors highlights the importance of long-term efficacious treatment. To effectively counsel and treat patients with actinic keratoses, dermatologists must understand how newer therapeutic approaches with mechanisms of action that have more rapid onset of action, shorter treatment courses, and less intense local skin reaction (LSRs) may promote adherence and improve long-term outcomes. J Drugs Dermatol. 2021;20(8):888-893. doi:10.36849/JDD.6078 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE SCROLL DOWN TO ACCESS THE FULL fTEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS.

摘要

背景

光化性角化病(AK)是一种具有潜在恶性的肿瘤,其向侵袭性鳞状细胞癌(SCC)进展的风险定义不明确。由于 AK 治疗通常需要反复进行,因此治疗效果和患者的依从性都会对治疗结果产生影响。

目的

综合现有最新文献,得出指导 AK 管理的总体原则,以改善患者体验和治疗结果。

方法

对 AK 的流行病学、自然史、预后、治疗以及 AK 治疗作用机制和依从性等方面进行系统文献检索,然后由 10 名皮肤科专家和皮肤科病理学家组成的专家共识小组对文献进行回顾,并使用改良 Delphi 流程就 AK 的发病机制和管理制定相关声明。最终声明只有获得超级多数票(≥7/10)才能通过。

结果

该小组制定了 7 条关于 AK 发病机制和管理的共识声明。

结论

AK 进展为侵袭性 SCC 的风险定义不明确,且没有被普遍接受的临床-组织病理学因素,这突出表明长期有效治疗的重要性。为了有效为 AK 患者提供咨询和治疗,皮肤科医生必须了解具有更快起效时间、更短治疗疗程和更少局部皮肤反应(LSR)作用机制的新型治疗方法,因为这些方法可能会提高患者的依从性并改善长期预后。皮肤病药物杂志。2021;20(8):888-893.doi:10.36849/JDD.6078 本文已免费提供。请向下滚动以在无需登录的情况下访问本文的全文。无需购买。如有任何疑问,请与出版商联系。

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