Non-melanoma Skin Cancer in Canada Chapter 3: Management of Actinic Keratoses

J Cutan Med Surg. 2015 May-Jun;19(3):227-38. doi: 10.1177/1203475415583414. Epub 2015 Apr 29.

Abstract

Background: Actinic keratosis (AK) and cheilitis (AC) are lesions that develop on photodamaged skin and may progress to form invasive squamous cell carcinomas (SCCs).

Objective: To provide guidance to Canadian health care practitioners regarding management of AKs and ACs.

Methods: Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines).

Results: Treatment of AKs allows for secondary prevention of skin cancer in sun-damaged skin. Because it is impossible to predict whether a given AK will regress, persist, or progress, AKs should ideally be treated. This chapter discusses options for the management of AKs and ACs.

Conclusions: Treatment options include surgical removal, topical treatment, and photodynamic therapy. Combined modalities may be used in case of inadequate response. AKs are particularly common following the long-term immunosuppression in organ transplant patients, who should be monitored frequently to identify emerging lesions that require surgery.

Keywords: actinic cheilitis; actinic keratosis; cryosurgery; fluorouracil; imiquimod; ingenol mebutate; photodynamic therapy.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminoquinolines / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Canada
  • Cryosurgery
  • Female
  • Humans
  • Imiquimod
  • Keratosis, Actinic / therapy*
  • Male
  • Photochemotherapy

Substances

  • Aminoquinolines
  • Antineoplastic Agents
  • Imiquimod