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Actinic keratoses

R E Genders, S Beck, J N Bouwes Bavinck, H A M van den Munckhof, S T P Kouwenhoven, M N C de Koning, F R de Gruijl, D Jenkins, R Willemze, K D Quint
BACKGROUND: For selecting therapy it is important to distinguish different types of keratinocytic neoplasia. It is sometimes difficult to make histopathologic diagnosis, especially in organ transplant recipients (OTR) who develop numerous lesions. METHODS: To investigate p16 immunostaining in different types of keratinocytic neoplasia in OTR, we studied 59 actinic keratoses(AK), 51 Bowen' s disease(BD), 63 squamous cell carcinomas(SCC) , 16 benign keratotic lesions(BKL) from 31 OTR patients and 25 controls (eczema and psoriasis)...
October 7, 2016: Journal of Cutaneous Pathology
Radek Wojcik, Julia Lowin, David Vilardell, Silvia Maeso, Leonardo Ruiz, John Lear, Colin Morton
OBJECTIVE: The objective of this analysis was to estimate the relative cost-effectiveness of Actikerall * (5-FU-SA) versus cryotherapy in a secondary care setting in the UK, for lesion-directed treatment in patients with actinic keratoses (AK) of the face and scalp. METHODS: The model was a simple decision tree, with a 6-month time horizon. The perspective was that of the UK National Health Service (NHS). Modelled treatment effects included reported per-patient histological clearance and recurrence rates...
October 7, 2016: Journal of Medical Economics
Zainab Jiyad, Peter O'Rourke, H Peter Soyer, Adèle C Green
Actinic keratoses (AKs) are common lesions that are usually diagnosed clinically. We sought to examine the accuracy of AK counts on digital photographs when compared with clinical examination counts. Skin sites of renal transplant recipients were examined clinically and on digital photographs by independent dermatologically-trained examiners. Specificity, sensitivity and Kendall's tau-b correlation coefficient were calculated based on exact photographic AK counts as well as counts with ± 1 AK tolerance...
October 4, 2016: Acta Dermato-venereologica
Gita Faghihi, Azam Elahipoor, Fariba Iraji, Shadi Behfar, Bahareh Abtahi-Naeini
Introduction. Actinic keratoses (AKs), a premalignant skin lesion, are a common lesion in fair skin. Although destructive treatment remains the gold standard for AKs, medical therapies may be preferable due to the comfort and reliability .This study aims to compare the effects of topical 1% colchicine gel and 3% diclofenac sodium gel in AKs. Materials and Methods. In this randomized double-blind study, 70 lesions were selected. Patients were randomized before receiving either 1% colchicine gel or 3% diclofenac sodium cream twice a day for 6 weeks...
2016: Advances in Medicine
Peter W Hashim, John K Nia, Skylar Singer, Gary Goldenberg
OBJECTIVES: To evaluate the safety and efficacy of ingenol mebutate 0.05% gel after cryosurgery versus cryosurgery alone for the treatment of hypertrophic and nonhypertrophic actinic keratosis on the dorsal hands. DESIGN: Investigator-blinded split arm study. SETTING: Academic institution. PARTICIPANTS: Sixteen subjects with actinic keratoses on dorsal hands. RESULTS: There was a mean reduction in the number of hypertrophic actinic keratosis lesions adjusted for baseline in ingenol mebutate-treated versus control group of -4...
July 2016: Journal of Clinical and Aesthetic Dermatology
Karina Paci, Rebecca Todd Bell, Beth Goldstein
No abstract text is available yet for this article.
August 2016: Cutis; Cutaneous Medicine for the Practitioner
T Hommel, R-M Szeimies
Actinic keratosis (AK) is a very common skin diagnosis in office-based dermatology. Due to the demographic changes with increasing numbers of elderly people, the proportion of patients with AK is expected rise. In order to avoid progression into squamous cell carcinoma, early treatment is recommended. Numerous treatment options are currently available for this purpose. In addition to targeted therapies for isolated AK many field-directed treatment modalities are available. However, the treatment option that is finally chosen depends on a variety of factors (e...
September 9, 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Steffen Emmert, Holger A Haenssle, John R Zibert, Margarete Schön, Andreas Hald, Maria H Hansen, Thomas Litman, Michael P Schön
UNLABELLED: The rapid and strong clinical efficacy of the first-in-class, ingenol mebutate, against actinic keratosis (AK) has resulted in its recent approval. We conducted the first comprehensive analysis of the cellular and molecular mode of action of topical ingenol mebutate 0.05% gel in both AK and uninvolved skin of 26 patients in a phase I, single-center, open-label, within-patient comparison. As early as 1 day after application, ingenol mebutate induced profound epidermal cell death, along with a strong infiltrate of CD4+ and CD8+ T-cells, neutrophils, and macrophages...
2016: PloS One
Thomas L Diepgen
Occupational skin diseases according to BK No. 5101 - "severe or recurrent skin diseases which have forced the person to discontinue all occupational activities that caused or could cause the development, worsening, or recurrence of the disease" - is the most commonly reported notifiable occupational diseases in Germany. Following the optimization of measures of primary, secondary, and tertiary prevention, today most individuals affected are able to continue their profession. With the revision of the German ordinance on occupational diseases (BKV) in January 2015, skin cancer caused by UV irradiation was added to the list of occupational diseases...
September 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
James M Spencer, Scott A Freeman
INTRODUCTION: Photodynamic Therapy (PDT) with topical Levulan is an approved and efficacious method for treating actinic keratoses. This therapy depends on the ability of the Levulan (delta amino levulinic acid) to penetrate the stratum corneum and enter the cells of the epidermis. Microneedling is an increasing popular cosmetic therapy in which an array of tiny needles is used to make holes in the epidermis and presumably induce a wound healing cascade that leads to cosmetic improvement of the skin...
September 1, 2016: Journal of Drugs in Dermatology: JDD
Cristina Zane, Antonella Fabiano, Mariachiara Arisi, Piergiacomo Calzavara-Pinton
BACKGROUND: Photodynamic therapy with methyl aminolevulinate (MAL-PDT) and ingenol mebutate gel (IMB) are approved therapeutic options for multiple actinic keratoses (AKs). OBJECTIVE: The aim of this intraindividual, split-face, randomized clinical trial was to compare treatment outcomes of MAL-PDT and IMB. METHODS: Two symmetrical contralateral areas with a similar number of AKs were selected and randomly assigned to 3 days of an IMB treatment cycle or a single session of MAL-PDT...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Vieri Grandi, Irene Baldi, Pietro Cappugi, Moira Mori, Nicola Pimpinelli
BACKGROUND: Actinic Keratoses (AK) are considered a form of in situ Squamous Cell Carcinoma (SCC) arising on chronically photoexposed skin. PDT with ALA or MAL is an effective treatment for multiple AK due its high Overall Response Ratio (ORR) but is burdened by important drawbacks: time-consumption, pain and high costs. Indole-3 acetic acid (IAA) is a newly described photosensitizer with proven clinical efficacy on seborrheic dermatitis and acne vulgaris. The aim of the study was to assess efficacy, safety and tolerability of a cycle of IAA-PDT at 0...
August 23, 2016: Photodiagnosis and Photodynamic Therapy
U Reinhold, I Hadshiew, A Melzer, A Prechtl
BACKGROUND: As an in-situ carcinoma, actinic keratoses should be treated early. Previous studies on the efficacy of a low-dose 0.5% 5-fluorouracil solution in combination with 10% salicylic acid (low-dose 5-FU/SA) are relating mostly to lesions of the head and face area. In contrast, AK lesions of the upper extremities are considered to be difficult to treat. OBJECTIVE: The efficacy of low-dose 5-FU/SA in the treatment of actinic keratoses on the hands and/or forearms was studied for the first time in this non-interventional study (NIS) under practical conditions in a large patient population...
August 23, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Kayo Kunimoto, Fukumi Furukawa, Mikiko Uede, Makoto Mizuno, Yuki Yamamoto
It is well known that the trigger for actinic keratosis (AK) mainly depends on UV exposure. We evaluated the effects of long-term use of sunscreen on the histopathological and dermoscopic changes of AK in aged patients. Eighteen months use of sunscreen produced no change in the number of actinic keratoses or the advancement of histological grade. Although a significant decrease was not observed in the number of positive cells of p53, Ki-67 and COX-2 of the subjects who used sunscreen for 18 months, the downward tendencies of these proteins were observed...
August 2016: Experimental Dermatology
Erica Moggio, Mariachiara Arisi, PierGiacomo Calzavara-Pinton
INTRODUCTION: Daylight photodynamic therapy with methyl aminolaevulinate (dlPDT) and ingenol mebutate gel (IMB) are approved therapeutic options for multiple actinic keratoses (AKs). The aim of this comparative, intra-patient, split- face, randomized clinical trial was to compare treatment outcomes of dlPDT and IMB. METHODS: Two symmetrical contralateral areas of 25cm(2) harboring a similar (≥5) number of AKs were selected and randomly assigned to 3 days' IMB treatment cycle or an only session of dlPDT...
August 13, 2016: Photodiagnosis and Photodynamic Therapy
E Kohl, C Popp, F Zeman, P Unger, M Koller, M Landthaler, S Karrer, R-M Szeimies
BACKGROUND: The efficacy of photodynamic therapy (PDT) with intense pulsed light (IPL) has been shown for treating actinic keratoses (AK) and improving photoaged skin in the face but not yet on the dorsal hands. OBJECTIVE: To evaluate the efficacy of PDT with IPL for treating AK of the dorsal hands, inducing neocollagenesis, and improving photoaged skin. METHODS: In this prospective, randomized, placebo-controlled, monocentric, within-patient, observer-blinded trial, patients with 1 to 4 mild-to-moderate AK on the dorsal hands were randomly allocated to two different treatment groups: methyl aminolevulinate (MAL) and IPL (λ ≥600nm, 16...
August 12, 2016: British Journal of Dermatology
M Ulrich, U Reinhold, T Skov, R Elvang Søndergaard, P Guitera
BACKGROUND: To date, studies with ingenol mebutate gel have used clinical clearance, not histological clearance, as a primary efficacy endpoint. OBJECTIVES: This phase 1, multicentre, single-arm, open-label study sought to histologically confirm clinical clearance of actinic keratoses (AKs) to support a treatment effect deep in the epidermis. METHODS: Patients (n = 108) aged ≥18 years with histologically confirmed AK within a 25-cm(2) contiguous treatment area on the trunk and extremities received ingenol mebutate 0...
August 12, 2016: British Journal of Dermatology
Carlo Mainetti, Caroline Guillod, Sandra Leoni-Parvex
Ingenol mebutate (IM) has recently been approved for the topical treatment of actinic keratoses. It appears to have a dual mechanism of action: rapid necrosis after gel application and a subsequent immune-mediated response, which targets any residual dysplastic epidermal cells. We report the successful treatment of a woman, who had been relapsing into Bowen's disease (BD) on her right forefinger for 8 years. During her clinical history, she had received an allogeneic, HLA-identical stem cell transplant for myeloproliferative syndrome with a JAK2V617F mutation and lobectomy of the pulmonary right lower lobe for adenocarcinoma...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Michael Mühlstädt
We present the case of a 73-year-old male patient who had received a first renal transplant at 36 years and a second one at the age of 55 years. He is currently under immunosuppression with everolimus 2.5 mg/day and prednisone 5 mg/day. The patient presented with multiple actinic keratoses on both cheeks and the forehead and received treatment by ingenol mebutate 150 µg/g gel daily on 3 consecutive days on his right cheek and methyl aminolevulinate (MAL) photodynamic therapy activated by daylight (MAL-dPDT) on the forehead and the left cheek...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
J A Siegel, K Korgavkar, M A Weinstock
Actinic keratoses (AKs) are common, with prevalence in the U.S.A. estimated at almost 40 million in 2004 and annual costs of > $1 billion (U.S.D.). However, there is no universally accepted definition of AK and thus it is difficult to identify reliably. AKs are lesions of epidermal keratinocytic dysplasia that result from chronic sun exposure and have the ability to progress to invasive squamous cell carcinoma (SCC), but clinicians disagree about whether AKs are premalignant lesions, superficial SCCin situ or epiphenomena of chronically sun-damaged skin...
August 8, 2016: British Journal of Dermatology
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