{"id":385024,"date":"2024-10-09T00:01:00","date_gmt":"2024-10-08T22:01:00","guid":{"rendered":"https:\/\/medizinonline.com\/guideline-with-updated-treatment-recommendations\/"},"modified":"2024-10-08T21:33:17","modified_gmt":"2024-10-08T19:33:17","slug":"guideline-with-updated-treatment-recommendations","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/guideline-with-updated-treatment-recommendations\/","title":{"rendered":"Guideline with updated treatment recommendations"},"content":{"rendered":"\n

Whether a decision is made to treat actinic keratoses or simply observe the lesions initially depends on various factors.\nThe assessment of how high the risk of progression to cutaneous squamous cell carcinoma is plays a key role.\nWhen selecting the appropriate treatment option, lesion characteristics and patient-related features must be taken into account. <\/strong><\/p>\n\n\n\n\n\n\n\n

At the EADO Annual Meeting, Dr Nicole Kelleners-Smeets from the Department of Dermatology at Maastricht University Medical Centre (NL) explained the recommendations of the new interdisciplinary guideline on the diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field carcinogenesis published in JEADV in 2024 [1,2].\nVarious European specialist associations were significantly involved in the creation of the guidelines, including EADO (European Association of Dermato-Oncology),<\/em> EDF (European Dermatology Forum) <\/em>andEADV (European Academy of Dermatology and Venereology)<\/em> [2].\nThe speaker is one of the many co-authors, so this is first-hand knowledge, so to speak [1,2]. <\/p>\n\n\n\n

AK = actinic keratosis
ALA = aminolevulinic acid
5-FU = 5-fluorouracil
MAL = methylaminolevulinate
PDT = photodynamic therapy
SA = salicylic acid<\/td>		<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Determine therapy indication on a case-by-case basis <\/h3>\n\n\n\n

Actinic keratosis (AK) is by definition a precancerous lesion that can progress into an invasive cutaneous squamous cell carcinoma (cSCC).\nAKs typically present as scaly or hyperkeratotic macules or plaques that occur singly or confluently (“field carcinomatization”).\nA treatment indication should be case-based, taking into account patient-related factors and the characteristics of the lesion, explained the speaker [1].\nAmong other things, the localization and extent of the lesions, age, comorbidity, skin cancer history, immunosuppression and patient preferences should be taken into account.\nIf there is an increased risk, for example due to the presence of numerous AKs, a history of cSCC and\/or current immunosuppressive treatment, Dr. Kelleners-Smeets advised patients to be persuaded to have their AKs treated [1].\nThe risk of AK progressing to cSCC is reported to be 0.025-20% per year.\nIn patients with a history of cSCC in the area of the AK field, the risk of developing another cSCC within 5 years is 40%.\nHowever, the risk of progression is also significantly increased in immunosuppressed patients.\nIf a lesion is suspected to be AK, the diagnostic clarification is primarily based on the clinical presentation and dermoscopic features.\nIf there are indications that it could be a cSCC or another differential diagnosis, a biopsy should be performed. <\/p>\n\n\n\n

If it is AK according to the overall diagnostic assessment, it is classified as follows: <\/p>\n\n\n\n