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Diagnose und Therapie aktinischer Keratosen: Diagnosis and therapy of actinic keratosis.
Thamm, Janis Raphael; Welzel, Julia; Schuh, Sandra.
Afiliação
  • Thamm JR; Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg.
  • Welzel J; Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg.
  • Schuh S; Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg.
J Dtsch Dermatol Ges ; 22(5): 675-691, 2024 May.
Article em De | MEDLINE | ID: mdl-38730534
ABSTRACT
Actinic keratosis (AK) is considered a chronic and recurring in situ skin neoplasia, with a possible transformation into invasive squamous cell carcinoma (SCC). Among others, predominant risk factors for development of AK are UV-light exposure and immunosuppression. Basal epidermal keratinocyte atypia (AK I) and proliferation (PRO Score) seem to drive malignant turnover, rather than clinical appearance of AK (Olsen I-III). Due to the invasiveness of punch biopsy, those histological criteria are not regularly assessed. Non-invasive imaging techniques, such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM) and line-field confocal OCT (LC-OCT) are helpful to distinguish complex cases of AK, Bowen's disease and SCC. Moreover, LC-OCT can visualize the epidermis and the papillary dermis at cellular resolution, allowing real-time PRO Score assessment. The decision-making for implementation of therapy is still based on clinical risk factors, ranging from lesion- to field-targeted and ablative to non-ablative regimes, but in approximately 85% of the cases a recurrence of AK can be observed after a 1-year follow-up. The possible beneficial use of imaging techniques for a non-invasive follow-up of AK to detect recurrence or invasive progression early on should be subject to critical evaluation in further studies.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: De Revista: J Dtsch Dermatol Ges Assunto da revista: DERMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: De Revista: J Dtsch Dermatol Ges Assunto da revista: DERMATOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de publicação: Alemanha