Hofbauer Günther, Anliker Mark, Boehncke Wolf-Henning, Brand Christoph, Braun Ralph, Gaide Olivier, Hafner Jürg, Hunger Robert, Itin Peter, Kaeuper Gina, Lautenschlager Stephan, Mainetti Carlo, Streit Markus
Dermatologische Klinik, UniversitätsSpital Zürich, Switzerland.
Klinik für Dermatologie/Allergologie, Kantonsspital St. Gallen, Switzerland.
Swiss Med Wkly. 2014 Dec 24;144:w14026. doi: 10.4414/smw.2014.14026. eCollection 2014.
Actinic keratosis (AK) affects millions of people worldwide, and its prevalence continues to increase. AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise the consideration of a diagnosis of field cancerization. Effective treatment of individual lesions as well as field cancerization is essential for good long-term outcomes. The Swiss Registry of Actinic Keratosis Treatment (REAKT) Working Group has developed clinical practice guidelines for the treatment of field cancerization in patients who present with AK. These guidelines are intended to serve as a resource for physicians as to the most appropriate treatment and management of AK and field cancerization based on current evidence and the combined practical experience of the authors. Treatment of AK and field cancerization should be driven by consideration of relevant patient, disease, and treatment factors, and appropriate treatment decisions will differ from patient to patient. Prevention measures and screening recommendations are discussed, and special considerations related to management of immunocompromised patients are provided.
光化性角化病(AK)在全球影响着数百万人,且其患病率持续上升。AK 皮损由长期紫外线辐射暴露引起,存在两个或更多 AK 皮损以及光损伤时,应考虑诊断为场癌化。有效治疗单个皮损以及场癌化对于良好的长期预后至关重要。瑞士光化性角化病治疗注册中心(REAKT)工作组已制定了针对患有 AK 的患者场癌化治疗的临床实践指南。这些指南旨在为医生提供资源,以便根据当前证据和作者的综合实践经验,对 AK 和场癌化进行最合适的治疗和管理。AK 和场癌化的治疗应考虑相关的患者、疾病和治疗因素,合适的治疗决策因患者而异。文中讨论了预防措施和筛查建议,并提供了与免疫功能低下患者管理相关的特殊注意事项。