Heppt Markus V
Hautklinik, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Deutschland.
Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054, Erlangen, Deutschland.
Dermatologie (Heidelb). 2024 Oct;75(10):815-822. doi: 10.1007/s00105-024-05376-x. Epub 2024 Jul 12.
Actinic keratosis (AK) is among the most common conditions in dermatology in an increasingly aging population. However, the presence of severe field cancerization with large treatment fields showing multiple lesions with distinct features often poses a therapeutic challenge. The most accurate possible characterization of the treatment field, risk assessment concerning the occurrence of cutaneous squamous cell carcinoma, and knowledge of the efficacy and local side effects of the available interventions are of paramount importance for effective management and preventive efforts. This article summarizes current developments in the diagnosis and treatment of AK and discusses their application in everyday clinical practice. In particular, the focus is on the increasing value of non-invasive diagnostic techniques like "line-field" confocal optical coherence tomography, and the recently approved topical agents tirbanibulin 1% ointment and 5‑fluorouracil 4% cream, as well as current developments of photodynamic therapy and prevention.
光化性角化病(AK)是皮肤科在人口老龄化日益加剧的情况下最常见的病症之一。然而,严重的场癌化现象存在,即大的治疗区域出现多个具有不同特征的病变,这常常带来治疗挑战。对治疗区域进行尽可能准确的特征描述、评估皮肤鳞状细胞癌发生的风险,以及了解现有干预措施的疗效和局部副作用,对于有效管理和预防工作至关重要。本文总结了AK诊断和治疗的当前进展,并讨论了它们在日常临床实践中的应用。特别值得关注的是,“线场”共聚焦光学相干断层扫描等非侵入性诊断技术的价值日益凸显,以及最近获批的外用药物1%替拉瑞林软膏和4% 5-氟尿嘧啶乳膏,还有光动力疗法和预防方面的当前进展。