Limits...
Primary care review of actinic keratosis and its therapeutic options: a global perspective.

Chetty P, Choi F, Mitchell T - Dermatol Ther (Heidelb) (2015)

Bottom Line: The higher incidence of AK in fair-skinned people in Australia has resulted in well-established management strategies and guidelines for its treatment, compared with countries with lower incidence.Primary care physicians are often the first to see this condition in their patients and are perfectly placed to educate the public and raise awareness.It is therefore desirable that their education and knowledge about AK and its treatment are up to date.

View Article: PubMed Central - PubMed

Affiliation: Beach Avenue Medical Clinic, Peachland, BC, Canada, drpchetty@gmail.com.

ABSTRACT
Actinic keratosis (AK) is a common skin condition caused by long-term sun exposure that has the potential to progress to non-melanoma skin cancers. The objective of this review is to examine the therapeutic options and management of AK globally, particularly in Australia, Canada, and the United Kingdom. Despite its potentially malignant nature, general awareness of AK is low, both in the general population and in the primary health care setting, especially in countries with low incidence. There is no standard therapeutic strategy for AK; it is treated through a variety of lesion-directed or field-directed therapies or a combination of both. A variety of treatment options are used depending on the experience of the primary care physician, the pathology of the lesion, and patient factors. Studies have shown that the physicians do not always use the optimal treatment option because of a lack of knowledge. The higher incidence of AK in fair-skinned people in Australia has resulted in well-established management strategies and guidelines for its treatment, compared with countries with lower incidence. It is essential to raise the awareness of AK because of its potential to progress to invasive squamous cell carcinoma. Primary care physicians are often the first to see this condition in their patients and are perfectly placed to educate the public and raise awareness. It is therefore desirable that their education and knowledge about AK and its treatment are up to date.

No MeSH data available.


Related in: MedlinePlus

Pustulation in a patient with marked AK a pre-treated with retinoic acid and b followed by methyl aminolevulinate photodynamic therapy. AK Actinic keratosis. Reproduced with permission from Tran and Salmon [43]
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4374063&req=5

Fig3: Pustulation in a patient with marked AK a pre-treated with retinoic acid and b followed by methyl aminolevulinate photodynamic therapy. AK Actinic keratosis. Reproduced with permission from Tran and Salmon [43]

Mentions: For treatment strategies to succeed, physicians and patients need to agree on a treatment plan that is understood by the patient to promote high adherence. For the physician, treatment choice will depend on disease-related factors: the patient profile (e.g., existing comorbidities); the cost of treatment; and patient preference. Understandably, both patients and physicians wish to combine high efficacy with minimal side effects. This is one reason why 5-FU cream, with its significant side effects, is less often used [24]. In addition, the photosensitizing effects of some topical agents, such as 5-FU, will discourage some patients from selecting this approach. Nonetheless, it should be noted that patient tolerance of side effects can vary and depend on factors such as age, physical health, and presence of comorbidities. Consequently, it is imperative that patients are informed about the efficacy and side effects of the available treatments. The cosmetic effects of the treatment are also an important consideration for some patients, as the side effects can be very pronounced and visually obvious and consequently result in psychosocial difficulties (Fig. 3) [43]. Therefore, treatment choice for patients depends both on the cost of the treatment and the length of its side effects.Fig. 3


Primary care review of actinic keratosis and its therapeutic options: a global perspective.

Chetty P, Choi F, Mitchell T - Dermatol Ther (Heidelb) (2015)

Pustulation in a patient with marked AK a pre-treated with retinoic acid and b followed by methyl aminolevulinate photodynamic therapy. AK Actinic keratosis. Reproduced with permission from Tran and Salmon [43]
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374063&req=5

Fig3: Pustulation in a patient with marked AK a pre-treated with retinoic acid and b followed by methyl aminolevulinate photodynamic therapy. AK Actinic keratosis. Reproduced with permission from Tran and Salmon [43]
Mentions: For treatment strategies to succeed, physicians and patients need to agree on a treatment plan that is understood by the patient to promote high adherence. For the physician, treatment choice will depend on disease-related factors: the patient profile (e.g., existing comorbidities); the cost of treatment; and patient preference. Understandably, both patients and physicians wish to combine high efficacy with minimal side effects. This is one reason why 5-FU cream, with its significant side effects, is less often used [24]. In addition, the photosensitizing effects of some topical agents, such as 5-FU, will discourage some patients from selecting this approach. Nonetheless, it should be noted that patient tolerance of side effects can vary and depend on factors such as age, physical health, and presence of comorbidities. Consequently, it is imperative that patients are informed about the efficacy and side effects of the available treatments. The cosmetic effects of the treatment are also an important consideration for some patients, as the side effects can be very pronounced and visually obvious and consequently result in psychosocial difficulties (Fig. 3) [43]. Therefore, treatment choice for patients depends both on the cost of the treatment and the length of its side effects.Fig. 3

Bottom Line: The higher incidence of AK in fair-skinned people in Australia has resulted in well-established management strategies and guidelines for its treatment, compared with countries with lower incidence.Primary care physicians are often the first to see this condition in their patients and are perfectly placed to educate the public and raise awareness.It is therefore desirable that their education and knowledge about AK and its treatment are up to date.

View Article: PubMed Central - PubMed

Affiliation: Beach Avenue Medical Clinic, Peachland, BC, Canada, drpchetty@gmail.com.

ABSTRACT
Actinic keratosis (AK) is a common skin condition caused by long-term sun exposure that has the potential to progress to non-melanoma skin cancers. The objective of this review is to examine the therapeutic options and management of AK globally, particularly in Australia, Canada, and the United Kingdom. Despite its potentially malignant nature, general awareness of AK is low, both in the general population and in the primary health care setting, especially in countries with low incidence. There is no standard therapeutic strategy for AK; it is treated through a variety of lesion-directed or field-directed therapies or a combination of both. A variety of treatment options are used depending on the experience of the primary care physician, the pathology of the lesion, and patient factors. Studies have shown that the physicians do not always use the optimal treatment option because of a lack of knowledge. The higher incidence of AK in fair-skinned people in Australia has resulted in well-established management strategies and guidelines for its treatment, compared with countries with lower incidence. It is essential to raise the awareness of AK because of its potential to progress to invasive squamous cell carcinoma. Primary care physicians are often the first to see this condition in their patients and are perfectly placed to educate the public and raise awareness. It is therefore desirable that their education and knowledge about AK and its treatment are up to date.

No MeSH data available.


Related in: MedlinePlus