Evidence‐ and consensus‐based (S3) Guidelines for the Treatment of Actinic Keratosis – International League of Dermatological Societies in cooperation with the European Dermatology Forum – Short version

  title={Evidence‐ and consensus‐based (S3) Guidelines for the Treatment of Actinic Keratosis – International League of Dermatological Societies in cooperation with the European Dermatology Forum – Short version},
  author={Ricardo Niklas Werner and E Stockfleth and Suzanne M. Connolly and Osvaldo Correia and Ricardo Erdmann and Peter Foley and A.K. Gupta and Anja Jacobs and Helmut Kerl and H.W. Lim and George M Martin and Maryse Paquet and David M. Pariser and Stefanie Rosumeck and H.-J. R{\"o}wert-Huber and Amandeep K. Sahota and Omar P. Sangueza and Stephen Shumack and Birte Sporbeck and Neil A. Swanson and Luis Antonio Torezan and Alexander Nast},
  journal={Journal of the European Academy of Dermatology and Venereology},
BACKGROUND Actinic keratosis (AK) is a frequent health condition attributable to chronic exposure to ultraviolet radiation. [] Key Method All recommendations were consented during a consensus conference using a formal consensus methodology. Strength of recommendations was expressed based on the GRADE approach. If expert opinion without external evidence was incorporated into the reasoning for making a certain recommendation, the rationale was provided.
Commentary on the “Evidence- and Consensus-Based (S3) Guidelines for the Treatment of Actinic Keratosis” Published by the International League of Dermatological Societies in Cooperation with the European Dermatology Forum
A guideline for the treatment of actinic keratosis does not meet the claim for an evidence- and consensus-based S3 guideline, but reveals strengths and weaknesses.
Cryosurgery combined with topical interventions for actinic keratosis: a systematic review and meta‐analysis
Actinic keratoses (AKs) are early in situ carcinomas of the skin caused by cumulative sun exposure. Cryosurgery is an easy and practicable lesion‐directed approach for treatment of isolated lesions.
Patient and physician satisfaction in an observational study with methyl aminolevulinate daylight photodynamic therapy in the treatment of multiple actinic keratoses of the face and scalp in six European countries
Guidelines recommend treating actinic keratoses (AKs) as they are recognized as precursors of invasive squamous cell carcinoma as well as other keratosis-related cancers.
Imiquimod 3.75% for field‐directed therapy of actinic keratosis: results of a prospective case‐series study in Greece
Clinical outcomes for the first 15 patients treated with imiquimod 3.75% in daily clinical practice in Greece show the detection of subclinical lesions and an increase in lesions to the maximum lesion count during treatment.
Local interventions for actinic keratosis in organ transplant recipients: a systematic review
Actinic keratosis in organ transplant recipients (OTRs) has a high risk of progressing to invasive squamous cell carcinoma of the skin and early treatment of AKs is warranted in OTRs.
Comparison of the Treatment Guidelines for Actinic Keratosis: A Critical Appraisal and Review
The purpose of this article is to review and compare guidelines published by Canadian, UK, and European groups for the management of AKs in patients.
Ingenol Mebutate Gel after Cryotherapy of Actinic Keratosis: When can I Start the Topical Treatment?
The experience with cryotherapy and ingenolmebutate used sequentially, without rest interval between both treatments is reported, to search a synergistic effect in field and lesion targeting therapies.
Italian expert consensus for the management of actinic keratosis in immunocompetent patients
The present review summarizes the existing evidence, reports the results of a consensus workshop on the management of AK, and recommends novel therapeutic options for solitary lesions.
Efficacy of photodynamic therapy combined with topical interventions for the treatment of actinic keratosis: a meta‐analysis
Photodynamic therapy (PDT) is a highly effective treatment option for patients with actinic keratoses (AK). However, efficacy can be reduced by insufficient illumination or hyperkeratotic nature of
The Relapse rate in patients with actinic keratosis treated with diclofenac sodium 3% gel
In this clinical trial topical therapy with diclofenac gel was demonstrated to be safe and effective overall for the treatment of actinic keratosis.


Epidemiology of solar keratoses
Solar keratoses (SKs) or actinic keratose are common dysplastic epidermal lesions which occur in pale‐skinned individuals who are chronically exposed to intense sunlight and constitute a major public health problem in such individuals.
Pathology and pathobiology of actinic (solar) keratosis – an update
Actinic keratosis is a UV light‐induced lesion and develops mostly in fair‐skinned patients being susceptible to solar damage and is considered as an early in situ squamous cell carcinoma 1,2 and are categorized in several classifications with subdivisions into three grades depending on the amount of atypical keratinocytes in the epidermis.
Actinic keratosis is an early in situ squamous cell carcinoma: a proposal for reclassification
An AK classification system is recommended that describes these lesions as squamous cell carcinomas (SCCs), using the terminology ‘ early in situ SCC Type AK I’, ‘early in situSCC type AK II’ and ‘in situ S CC Type AK III’ to give clinicians better guidance for diagnosis and specific treatment recommendations.
Actinic keratosis: a clinical and epidemiological revision.
The authors assemble the main epidemiological data regarding this disease and suggest that strategies to identify risky phenotypes, early diagnosis, adequate treatment, clinical follow-up, stimulus to skin self examination, photoeducation and photoprotection should be promoted with the aim of avoiding the progression to malignancy.
The natural history of actinic keratosis: a systematic review
No reliable estimates concerning the frequency of AK developing into invasive carcinoma can be given, and further studies are needed, as available data are limited.
Actinic keratosis: how to differentiate the good from the bad ones?
Clinical features of actinic keratoses that provide a practical guide to practitioners in the treatment of AK are found, including IDRBEU, which is the most common premalignant lesion in humans.
Solar (actinic) keratosis is squamous cell carcinoma
The issue of the fundamental character of solar keratosis became ever more bewildering when an American dermatologist, R.L. Sutton Jr, advanced a view contrary to the one propounded by Dubreuilh and given credence by Freudenthal, namely, conversion of the keratotic to carcinoma.
Prevention of non‐melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case–control study
Evidence for the prevention of NMSC in immunocompromised patients is still missing and encouraging reports of protective effects of broad‐spectrum sunscreens in Immunocompetent patients are still missing.
Histopathology of incipient intraepidermal squamous cell carcinoma ("actinic keratosis").
  • C. Cockerell
  • Medicine
    Journal of the American Academy of Dermatology
  • 2000
AKs are malignant neoplasms in evolution and demonstrate histologic and molecular genetic features of malignancy and it is proposed that the term actinic (solar) keratosis be eliminated.
Reduction of solar keratoses by regular sunscreen use.
Regular use of sunscreens prevents the development of solar keratoses and, by implication, possibly reduces the risk of skin cancer in the long-term.