Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

作者：Poulin Yves^*; Lynde Charles W; Barber Kirk; Vender Ronald; Claveau Joel; Bourcier Marc; Ashkenas John

来源：Journal of Cutaneous Medicine and Surgery, 2015, 19(3): 227-238.

DOI：10.1177/1203475415583414

• actinic keratosis
• actinic cheilitis
• photodynamic therapy
• cryosurgery
• imiquimod
• fluorouracil
• ingenol mebutate

Background: Actinic keratosis (AK) and cheilitis (AC) are lesions that develop on photodamaged skin and may progress to form invasive squamous cell carcinomas (SCCs). Objective: To provide guidance to Canadian health care practitioners regarding management of AKs and ACs.
Methods: Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines).
Results: Treatment of AKs allows for secondary prevention of skin cancer in sun-damaged skin. Because it is impossible to predict whether a given AK will regress, persist, or progress, AKs should ideally be treated. This chapter discusses options for the management of AKs and ACs.
Conclusions: Treatment options include surgical removal, topical treatment, and photodynamic therapy. Combined modalities may be used in case of inadequate response. AKs are particularly common following the long-term immunosuppression in organ transplant patients, who should be monitored frequently to identify emerging lesions that require surgery.

• 出版日期2015-6