Villani Alessia
Dermatologia Clinica, Dipartimento di Medicina Clinica e Chirurgia, Università Federico II, Napoli.
Recenti Prog Med. 2024 Oct;115(10):46e-47e. doi: 10.1701/4357.43477.
Actinic keratoses (AK) are common precancerous lesions usually arising on chronic sun-exposed areas. Field of cancerization (FC) is a chronically UV-exposed area in which subclinical multifocal AKs are found. Therapeutic choice is mainly made according to the Olsen grade of AKs. We report the case of a 76-year-old man with numerous AKs of the face and scalp. The patient had undergone numerous topical physical and medical therapies with poor results. On the left cheek, grade I and grade II AKs were found in a large FC, so he was prescribed topical therapy with tirbanibulin 1% ointment. After 10 days erythema and crusts were objectified and a burning sensation was reported on the area of application and on surrounding areas. At 8 weeks follow-up, the patient had total resolution of disease and no residual local side effects. Although tirbanibulin 1% ointment has indication for type I AKs of face and scalp, this case reported its efficacy and benefit also on type II AKs, demonstrating safety and a minimal and manageable degree of discomfort caused to the patient. Therefore, it fits fully among the treatments of grade I AKs but numerous still may be its indications as demonstrated in our case, where efficacy, safety and compliance were combined.
光化性角化病（AK）是常见的癌前病变，通常出现在长期暴露于阳光下的区域。癌变场（FC）是一个长期暴露于紫外线的区域，在其中可发现亚临床多灶性AK。治疗选择主要根据AK的奥尔森分级来做出。我们报告了一名76岁男性面部和头皮有大量AK的病例。该患者接受了多次局部物理和药物治疗，但效果不佳。在左脸颊，在一个大的FC区域发现了I级和II级AK，因此给他开了1%替巴尼布林软膏的局部治疗。10天后观察到红斑和结痂，患者报告在用药部位及周围区域有烧灼感。在8周的随访中，患者疾病完全消退，且无残留局部副作用。虽然1%替巴尼布林软膏适用于面部和头皮的I型AK，但本病例报告了其对II型AK也有效且有益，证明了其安全性以及给患者带来的不适程度最小且可控。因此，它完全适合I级AK的治疗，但正如我们病例所示，其适应证可能仍然很多，在该病例中疗效、安全性和依从性得到了结合。
