Dréno Brigitte, Lévy Pierre, Caillet Gregory, Touboul Chantal, Joubert Jean-Michel, Amici Jean-Michel
Nantes University, INSERM, CNRS, Immunology and New Concepts in Immunotherapy, UMR 1302/EMR6001, Nantes, France.
Paris-Dauphine University, PSL University, LEDA[LEGOS], Paris, France.
Acta Derm Venereol. 2025 Jan 26;105:adv42372. doi: 10.2340/actadv.v105.42372.
The objective of this retrospective observational study was to estimate the prevalence of actinic keratosis (AK) in individuals aged ≥ 40 years in France, to describe the characteristics of affected patients, and to describe treatments. A representative panel of 20,000 households with ≥ 1 member aged ≥ 40 years were invited to participate. Participants who reported AK lesions diagnosed by a physician were eligible. The study questionnaire collected data on demographics, lesion characteristics, Fitzpatrick phototype, diagnosis, and treatments. In total, 15,246 questionnaires (78.5%) were returned and 639 responders were eligible. The adjusted prevalence of AK was 4.03% (95% CI: 3.73-4.35). Prevalence is probably underestimated due to data collection by self-report and low awareness of AK. 177 participants (27.7%) were aged < 65 years. AK was diagnosed by a dermatologist for 521 participants (81.6%). Some 200 participants (31.3%) had no lesions at the time of the survey and 243 (37.9%) had never been treated; 312 participants (78.6%) were prescribed physical treatment, principally cryotherapy; and 125 (31.5%) were prescribed topical treatment, principally 5-fluorouracil or imiquimod. In conclusion, improving diagnosis of AK in everyday clinical practice is important to ensure that all individuals with AK are treated optimally and encouraged to take sun protection measures to prevent progression to SCC.
这项回顾性观察研究的目的是估计法国40岁及以上人群中光化性角化病（AK）的患病率，描述受影响患者的特征，并描述治疗情况。邀请了一个由20000户家庭组成的代表性样本，每户家庭中至少有一名40岁及以上的成员参与。报告有医生诊断的AK病变的参与者符合条件。研究问卷收集了有关人口统计学、病变特征、菲茨帕特里克皮肤分型、诊断和治疗的数据。总共回收了15246份问卷（78.5%），639名应答者符合条件。AK的校正患病率为4.03%（95%CI：3.73-4.35）。由于通过自我报告收集数据以及对AK的认识不足，患病率可能被低估。177名参与者（27.7%）年龄小于65岁。521名参与者（81.6%）的AK由皮肤科医生诊断。约200名参与者（31.3%）在调查时没有病变，243名（37.9%）从未接受过治疗；312名参与者（78.6%）接受了物理治疗，主要是冷冻疗法；125名（31.5%）接受了局部治疗，主要是5-氟尿嘧啶或咪喹莫特。总之，在日常临床实践中改善AK的诊断对于确保所有AK患者得到最佳治疗并鼓励他们采取防晒措施以防止进展为鳞状细胞癌非常重要。
