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播散性浅表性光化性汗孔角化症:系统治疗综述

Disseminated Superficial Actinic Porokeratosis: A Systematic Treatment Review.

作者信息

Tan Stephanie, Tan Ernest

机构信息

Sir Charles Gairdner Hospital, Nedlands, Western, Australia.

出版信息

Am J Clin Dermatol. 2025 Jan;26(1):7-21. doi: 10.1007/s40257-024-00903-x. Epub 2024 Nov 1.

Abstract

BACKGROUND

Disseminated superficial actinic porokeratosis (DSAP) is a disorder of keratinization characterised by small, brown plaques with elevated keratotic rims, typically occurring on sun exposed areas. DSAP poses a risk for malignant transformation, emphasising the need for effective management strategies.

OBJECTIVE

The aim of this study was to review the current reported management options for DSAP.

METHODS

This systematic review was based on a comprehensive search of databases (Cochrane, PubMed, Medline, Embase, Emcare, ProQuest, Web of Science, CINAHL) from inception to 15 March 2024. Studies reporting management of DSAP were included irrespective of study design.

RESULTS

Of 923 citations, 61 studies were included, predominantly comprising case reports and retrospective case series. A limited number of randomized and open-label trials were identified. Various treatment modalities were reported, including topical and systemic agents, photodynamic therapy, and laser therapy.

CONCLUSION

Multiple management options are available for DSAP, including topical and systemic agents, photodynamic therapy and laser treatments. However, these approaches vary in their balance between efficacy and toxicity. Currently, there is a paucity of high-quality clinical trial data to guide treatment decisions. Further studies are required to determine the most effective and safe management strategies for DSAP. PROSPERO REGISTRATION: CRD42024514558.

摘要

背景

播散性浅表性光化性汗孔角化症(DSAP)是一种角化异常疾病,其特征为小的褐色斑块,伴有角化性边缘隆起,通常发生于暴露于阳光的部位。DSAP存在恶变风险,这凸显了有效管理策略的必要性。

目的

本研究旨在综述目前报道的DSAP管理方案。

方法

本系统评价基于对数据库(Cochrane、PubMed、Medline、Embase、Emcare、ProQuest、Web of Science、CINAHL)从创建至2024年3月15日进行的全面检索。纳入报告DSAP管理情况的研究,无论其研究设计如何。

结果

在923篇文献中,纳入了61项研究,主要包括病例报告和回顾性病例系列。确定了数量有限的随机试验和开放标签试验。报道了多种治疗方式,包括局部和全身用药、光动力疗法和激光治疗。

结论

DSAP有多种管理方案可供选择,包括局部和全身用药、光动力疗法和激光治疗。然而,这些方法在疗效和毒性之间的平衡各不相同。目前,缺乏高质量的临床试验数据来指导治疗决策。需要进一步研究以确定DSAP最有效和安全的管理策略。PROSPERO注册号:CRD42024514558。

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