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actinic keratoses treatment

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
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
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
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
I Bobyr, A Campanati, V Consales, E Martina, E Molinelli, F Diotallevi, V Brisigotti, M Giangiacomi, G Ganzetti, K Giuliodori, A Offidani
BACKGROUND: Actinic keratosis (AK) is a cutaneous intraepithelial neoplasm that typically develops on sun-damaged skin. The incidence of AK is increasing worldwide, and it is accepted as the most frequent pre-malignant lesion in humans. OBJECTIVES: To demonstrate that ingenol mebutate gel is effective in the treatment of actinic keratoses because of its clinical, dermoscopic, capillaroscopic, histopathological and immunohistochemical treatment outcomes. METHODS: Sixty individuals with multiple non-hypertrophic AKs were enrolled into this non-randomized, open-label, prospective, trial...
July 25, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
C Ferrándiz, M J Plazas, M Sabaté, R Palomino
BACKGROUND: Actinic keratoses (AKs) are common skin lesions associated with an increased risk of developing squamous cell carcinoma. Few studies in Europe have focused on AK prevalence. AIM: To determine the point prevalence of AKs in a dermatology outpatient population in Spain, to describe the clinical characteristics of these lesions and to characterise the profile of AK patients. METHODS: Observational, cross-sectional, multicentre study conducted in 19 hospitals (dermatology outpatient services) around Spain...
October 2016: Actas Dermo-sifiliográficas
Pedro Herranz, Colin Morton, Thomas Dirschka, Rosario Rodríguez Azeredo, Rodrigo Roldán-Marín
BACKGROUND: Actinic keratosis (AK) lesions have the potential to develop into invasive squamous cell carcinomas (SCCs), and approaches to treatment are evolving to try to reduce the burden of SCC. OBJECTIVE: To present the published clinical research surrounding the use of 0.5% 5-fluorouracil with 10% salicylic acid (low-dose 5-FU/SA) for the treatment of hyperkeratotic AKs. METHOD: A review of published clinical evidence for low-dose 5-FU/SA for the treatment of AKs...
July 21, 2016: Journal of Cutaneous Medicine and Surgery
Pablo Fonda-Pascual, Oscar M Moreno-Arrones, Adrian Alegre-Sanchez, David Saceda-Corralo, Diego Buendia-Castaño, Cristina Pindado-Ortega, Pablo Fernandez-Gonzalez, Kyra Velazquez-Kennedy, María I Calvo-Sánchez, Antonio Harto-Castaño, Bibiana Perez-Garcia, Lorea Bagazgoitia, Sergio Vaño-Galvan, Jesus Espada, Pedro Jaen-Olasolo
Photodynamic therapy (PDT) is a clinical modality of photochemotherapy based on the accumulation of a photosensitizer in target cells and subsequent irradiation of the tissue with light of adequate wavelength promoting reactive oxygen species (ROS) formation and cell death. PDT is used in several medical specialties as an organ-specific therapy for different entities. In this review we focus on the current dermatological procedure of PDT. In the most widely used PDT protocol in dermatology, ROS production occurs by accumulation of the endogenous photosensitizer protoporphyrin IX after treatment with the metabolic precursors 5-methylaminolevulinic acid (MAL) or 5-aminolevulinic acid (ALA)...
July 12, 2016: Methods: a Companion to Methods in Enzymology
Julien Lanoue, Chen Chen, Gary Goldenberg
Field cancerization is the process in which a singular cell accumulates genetic mutations following carcinogen exposure and then divides to create a "field" of monoclonal premalignant cells. In this study, microscopically identified actinic keratoses (AKs) were used as markers of field cancerization in all excision specimens of squamous cell carcinomas (SCCs), basal cell carcinomas (BCCs), and malignant melanomas (MMs) received by our institution's dermatopathology department over a 3- to 6-month period. Our findings provide additional evidence for the theory of field cancerization, its association with cutaneous malignancies, and the need to assess the extent of field damage when determining treatment strategies...
June 2016: Cutis; Cutaneous Medicine for the Practitioner
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