Therapeutic Options for Actinic Keratoses and Squamous Cell Carcinoma in Situ
Authors:
M. Pásek 1
Authors‘ workplace:
Dermatovenerologická klinika 3. LF UK a FNKV, Praha, přednosta prof. MUDr. Petr Arenberger, DrSc., MBA, FCMA
1
Published in:
Čes-slov Derm, 96, 2021, No. 5, p. 207-220
Category:
Reviews (Continuing Medical Education)
Overview
Actinic keratoses (AK) are the most common precancerous lesions in the white Caucasian population due to long- -term exposure to ultraviolet (UV) radiation. Observations indicate its possible development into invasive cutaneous squamous cell carcinoma (cSCC). About 60–70% of invasive cSCC arises in pre-existing AK. Bowen's disease, bowenoid papulosis together with intraepithelial neoplasias (erythroplasia Queyrat), including penile vulvar and anal intraepithelial neoplasias, are classified as a group of squamous cell carcinomas in situ (Cis). Number of risk factors, especially UV radiation, chronic inflammation and infections with high-risk oncogenic HPV types 16 and 18, contribute to the etiology of Cis. Dermatoscopy, which is a highly sensitive, reliable, rapid and non-invasive diagnostic method, plays an important role in the diagnosis of AK. AK and Cis therapy can be divided into treatment focused on individual lesions (so-called lesion-directed therapy – e.g. cryotherapy, curettage, electrodesication, shave excision) or treatment focused on large areas (so-called field-directed therapy – e.g. 5 fluorouracil, imiquimod, ingenol mebutate, diclofenac sodium, photodynamic therapy).
Keywords:
Actinic keratosis – carcinoma in situ – dermatoscopy – Bowen’s disease – bowenoid papulosis – erythroplasia of Queyrat – penile intraepithelial neoplasia – vulvar intraepithelial neoplasia – high-grade squamous intraepithelial lesions – chemoprevention – lesion-directed therapy – field-directed therapy
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