The natural history of actinic keratosis: a systematic review

  title={The natural history of actinic keratosis: a systematic review},
  author={Ricardo Niklas Werner and Adel Sammain and Ricardo Erdmann and Vanessa Hartmann and E Stockfleth and Alexander Nast},
  journal={British Journal of Dermatology},
Knowledge about the development of untreated actinic keratosis (AK) and risk of progression into squamous cell carcinoma (SCC) is important. Therefore, we set out to synthesize primary data on the natural history of AK. We carried out a systematic literature search (Medline, Medline in Process, Embase, Cochrane) of studies on the natural course of AK, regarding (i) progression and regression rates per lesion‐year, (ii) changes in total lesion counts over time, and (iii) spontaneous field… 
Contemporary management of actinic keratosis
The most up-to-date evidence in the management of Actinic keratosis is summarized to mitigate the risk of malignant progression, including metastasis and death.
Current perspective on actinic keratosis: a review
Improved agreement among clinicians on AK definition may improve management, and treatments should aim to decrease the risk of KC or facilitate KC diagnosis by reducing the potential for misidentification created when a KC appears in a field of AKs.
Comprehensive management of actinic keratoses: practical integration of available therapies with a review of a newer treatment approach.
The major individual approaches to AK treatment based on available literature and common use in clinical practice are ablative therapy, topical field therapy and photodynamic therapy (PDT).6 Liquid nitrogen cryosurgery is the most frequently used ablative approach for AK treatment.
Spontaneous regression rates of actinic keratosis: a systematic review and pooled analysis of randomized controlled trials
It is concluded that only a few participants achieve complete regression of their AK without any active treatment and lesion clearance without active treatment is unlikely in OTR, which underline that early and consequent treatment of AK is recommended.
Treatment of Precancers with Topical Agents
With the incidence of nonmelanoma skin cancer on the rise, treatment for AKs has been recommended to reduce the development of invasive SCC, to lower healthcare expenditure and for patient well-being.
Actinic keratosis : do we have clinicopathological criteria to select lesions for therapy ?
Actinic keratoses (AKs) are defined clinically as erythematous and scaly plaques occurring on chronically sun-damaged skin as a result to exposure to ultraviolet radiation. They are typically located
Incidence of Actinic Keratosis and Risk of Skin Cancer in Subjects with Actinic Keratosis: A Population-based Cohort Study.
This study analysed the incidence of AK and the risk of skin cancer in patients with AK based on data obtained from the National Health Insurance System (NHIS) in South Korea.
Treating actinic keratosis
In their randomized controlled phase IIa trial, promising data is presented on the efficacy and safety of a new derivate of ingenol mebutate in the treatment of AK, with the highest concentration of LEO 43204 showing a statistically significantly higher reduction in lesion counts than ingenolmebutate.
Guidelines of care for the management of actinic keratosis.
Treatment considerations in actinic keratosis
  • G. Goldenberg
  • Medicine
    Journal of the European Academy of Dermatology and Venereology : JEADV
  • 2017
Therapies with shorter and simpler treatment courses are often associated with better adherence than treatments with longer courses and may represent more appropriate choices in patients for whom convenience and/or adherence are an issue.


Progression of actinic keratosis to squamous cell carcinoma revisited: clinical and treatment implications.
Although the rate of progression over time remains to be determined by large prospective studies, actinic keratosis is a marker for an increased rate of nonmelanoma skin cancer (NMSC), even in the absence of specific lesion progression.
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.
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.
The importance of early diagnosis and treatment of actinic keratosis.
Clinical evaluation of topical isotretinoin in the treatment of actinic keratoses.
Spontaneous remission of solar keratoses: the case for conservative management
There was a 21.8% increase in the total number of solar keratoses in the 1040 people studied in the 12‐month period, due to new lesions forming at the same time as remissions were occurring.
High incidence and regression rates of solar keratoses in a queensland community.
Solar keratosis prevalence increased with age in both sexes, and individuals with solar keratoses at baseline were over seven times more likely to develop additional solar ker atoses in the next 12 mo than those without prevalent solar keratography at baseline.
Chemoprevention of Human Actinic Keratoses by Topical
Topical tocopherol did not normalize established sun-induced lesions, but DL-α-tocopherol-induced reductions in polyamine metabolism are consistent with the inhibition of skin squamous cell carcinogenesis as seen in previous human trials and animal models.
Reliability of counting actinic keratoses before and after brief consensus discussion: the VA topical tretinoin chemoprevention (VATTC) trial.
Counts of actinic keratoses are commonly performed, but appear to be unreliable, even when performed by experienced dermatologists, and joint discussion of discrepancies may enhance the reliability of these counts, although substantial variation remains.