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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

Management of AK in United Kingdom [45]. AK Actinic keratosis, GPwSI general practitioner with a special interest, SCC squamous cell carcinoma, UV ultraviolet
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Related In: Results  -  Collection


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Fig5: Management of AK in United Kingdom [45]. AK Actinic keratosis, GPwSI general practitioner with a special interest, SCC squamous cell carcinoma, UV ultraviolet

Mentions: In Europe, a simple treatment algorithm to assist clinicians in the management of AK and to standardize and improve patient care was developed in 2008 by the European Skin Academy [24]. An update of these guidelines by the European Dermatology Forum indicated that there is a paucity of studies on the frequency and cost of AK treatment in Europe [28]. Clinical guidelines from the UK Primary Care Dermatology Society state that patients should be managed in the community if at all possible, and only referred to a consultant dermatologist in cases of diagnostic uncertainty or if the damage is widespread or severe [45]. These guidelines recommend both individual lesion treatment for few or widely spread lesions and field therapy for areas of skin with multiple AKs (Fig. 5). Cryosurgery is generally widely utilized within Europe and is an effective treatment for single AKs [24]. Alternative, non-invasive topical treatments such as imiquimod, PDT, diclofenac 3% gel, and ingenol mebutate gel are seen as promising options for treating larger areas of field cancerization [28, 45].Fig. 5


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

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

Management of AK in United Kingdom [45]. AK Actinic keratosis, GPwSI general practitioner with a special interest, SCC squamous cell carcinoma, UV ultraviolet
© Copyright Policy
Related In: Results  -  Collection

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

Fig5: Management of AK in United Kingdom [45]. AK Actinic keratosis, GPwSI general practitioner with a special interest, SCC squamous cell carcinoma, UV ultraviolet
Mentions: In Europe, a simple treatment algorithm to assist clinicians in the management of AK and to standardize and improve patient care was developed in 2008 by the European Skin Academy [24]. An update of these guidelines by the European Dermatology Forum indicated that there is a paucity of studies on the frequency and cost of AK treatment in Europe [28]. Clinical guidelines from the UK Primary Care Dermatology Society state that patients should be managed in the community if at all possible, and only referred to a consultant dermatologist in cases of diagnostic uncertainty or if the damage is widespread or severe [45]. These guidelines recommend both individual lesion treatment for few or widely spread lesions and field therapy for areas of skin with multiple AKs (Fig. 5). Cryosurgery is generally widely utilized within Europe and is an effective treatment for single AKs [24]. Alternative, non-invasive topical treatments such as imiquimod, PDT, diclofenac 3% gel, and ingenol mebutate gel are seen as promising options for treating larger areas of field cancerization [28, 45].Fig. 5

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