J Drugs Dermatol. 2022 Aug 1;21(8):845-849. doi: 10.36849/JDD.6704.
Difficulties faced by clinicians in routine clinical practice when selecting the appropriate treatment for patients with actinic keratosis (AK) include: the independent evaluation of AK lesions, the absence of a standardized definition of field cancerization (FC), and the lack of a reproducible classification to grade the entire AK-affected area. Moreover, to assess the severity of AK, most guidelines rely on lesion count, which is often not reproducible among specialists. The present work has 2 main objectives: first, to review and highlight some of the issues clinicians tackle when classifying and monitoring AK lesions and the status of FC, looking in more detail at some of the most commonly used clinical scales for classifying AK lesions. Second, we pose questions that we encounter in daily clinical practice, and whose answers or comments help to deal with cases of AK, facilitating the work of clinicians: How should we approach AK diagnosis? How do the challenges of clinical studies on the evaluation of treatment efficacy translate into clinical practice? We review the literature on the clinical classifications and management of AK, and propose how to guide the diagnosis, management, and monitoring of patients with AK. J Drugs Dermatol. 2022;21(8):845-849. doi:10.36849/JDD.6704.
临床医生在为光化性角化病（AK）患者选择合适的治疗方法时面临的困难包括：独立评估 AK 病变、缺乏对区域性癌前病变（FC）的标准化定义，以及缺乏可重复性分类来对整个 AK 病变区域进行分级。此外，为了评估 AK 的严重程度，大多数指南都依赖于病变计数，而专家之间的病变计数往往无法重现。本研究有 2 个主要目的：首先，回顾和强调临床医生在分类和监测 AK 病变和 FC 状态时遇到的一些问题，并更详细地研究一些最常用于 AK 病变分类的临床量表。其次，我们提出了在日常临床实践中遇到的问题，其答案或评论有助于处理 AK 病例，为临床医生提供便利：我们应该如何处理 AK 的诊断？评估治疗效果的临床研究中的挑战如何转化为临床实践？我们回顾了 AK 的临床分类和管理的文献，并提出了如何指导 AK 患者的诊断、管理和监测。J 皮肤病药物杂志。2022 年；21（8）：845-849. doi：10.36849/JDD.6704.
