Guidelines of Care for the Management of Actinic Keratosis: Executive Summary.

Abstract

BACKGROUND\nActinic keratoses (AK) are rough scaly patches that arise on chronically ultraviolet (UV)-exposed skin and can progress to keratinocyte carcinoma. Treatment options for AK include topical medications, photodynamic therapy (PDT), cryosurgery, and laser ablation.\n\n\nOBJECTIVE\nThis executive summary provides a synopsis of the 18 evidence-based recommendations for the treatment of AK detailed in the Guidelines of Care for the Management of Actinic Keratosis.\n\n\nMETHODS\nA multidisciplinary workgroup conducted a systematic review to address five clinical questions on the management of AKs and applied the GRADE approach for assessing the certainty of the evidence and formulating and grading clinical recommendations. Graded recommendations were voted on to achieve consensus.\n\n\nRESULTS\nAnalysis of the evidence resulted in 18 recommendations suggesting there are several effective treatments available for AK.\n\n\nLIMITATIONS\nThe analysis informing the recommendations was based on the best available evidence at the time it was conducted. The results of future studies may necessitate a revision of current recommendations.\n\n\nCONCLUSIONS\nStrong recommendations are presented for using UV protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery. Conditional recommendations are presented for the use of PDT and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.