Guidelines of care for the management of actinic keratosis

Daniel B. Eisen, Maryam M. Asgari, Daniel D. Bennett, Suzanne M. Connolly, Robert P. Dellavalle, Esther E. Freeman, Gary Goldenberg, David J. Leffell, Sue Peschin, James E. Sligh, Peggy A. Wu, Lindsy Frazer-Green, Sameer Malik, Todd E. Schlesinger

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Actinic keratoses (AK) are rough scaly patches that arise on chronically ultraviolet-exposed skin and can progress to keratinocyte carcinoma. Objective: This analysis examined the literature related to the management of AK to provide evidence-based recommendations for treatment. Grading, histologic classification, natural history, risk of progression, and dermatologic surveillance of AKs are also discussed. Methods: A multidisciplinary Work Group conducted a systematic review to address 5 clinical questions on the management of AKs and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading clinical recommendations. Graded recommendations were voted on to achieve consensus. Results: Analysis of the evidence resulted in 18 recommendations. Limitations: This analysis is based on the best available evidence at the time it was conducted. The pragmatic decision to limit the literature review to English language randomized trials may have excluded data published in other languages or limited identification of relevant long-term follow-up data. Conclusions: Strong recommendations are made for using ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery. Conditional recommendations are made for the use of photodynamic therapy and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.

Original languageEnglish (US)
Pages (from-to)e209-e233
JournalJournal of the American Academy of Dermatology
Volume85
Issue number4
DOIs
StatePublished - Oct 2021

Keywords

  • actinic keratosis
  • actinic keratosis guidelines
  • clinical guidelines for actinic keratosis
  • cryosurgery
  • dermatology
  • photodynamic therapy
  • topical agents

ASJC Scopus subject areas

  • Dermatology

Fingerprint

Dive into the research topics of 'Guidelines of care for the management of actinic keratosis'. Together they form a unique fingerprint.

Cite this