European consensus‐based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV‐induced dysplasia and field cancerization on behalf of European Association of Dermato‐Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes)

野战癌变 医学 皮肤病科 光化性角化病 指南 皮肤癌 光化性角化病 发育不良 癌症 病理 内科学 基底细胞
作者
Lidija Kandolf,Ketty Peris,Josep Malvehy,Klara Mosterd,Markus V. Heppt,Maria Concetta Fargnoli,Carola Berking,Petr Arenberger,Matilda Bylaitė-Bučinskienė,V. del Mármol,Thomas Dirschka,Brigitte Dréno,Ana‐Maria Forsea,Catherine Α. Harwood,A. Hauschild,Ida M. Heerfordt,Roland Kauffman,Nicole Kelleners‐Smeets,Aimilios Lallas,Célèste Lebbé,Ulrike Leiter,Caterina Longo,Željko Mijušković,Giovanni Pellacani,Susana Puig,Philippe Saïag,Mirna Šitum,Eggert Stockfleth,Carmen Sălăvăstru,Alexander J. Stratigos,Iris Zalaudek,Claus Garbe
出处
期刊:Journal of The European Academy of Dermatology and Venereology [Wiley]
卷期号:38 (6): 1024-1047 被引量:7
标识
DOI:10.1111/jdv.19897
摘要

A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.
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