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)
Lidija Kandolf
(1)
,
Ketty Peris
(2, 3)
,
Josep Malvehy
(4, 5, 6)
,
Klara Mosterd
(7, 8)
,
Markus Heppt
(9, 10)
,
Maria Concetta Fargnoli
(11)
,
Carola Berking
(9, 10)
,
Petr Arenberger
(12, 13)
,
Matilda Bylaite-Bučinskiene
(14)
,
Veronique del Marmol
(15)
,
Thomas Dirschka
(16, 17)
,
Brigitte Dreno
(18)
,
Ana‐maria Forsea
(19)
,
Catherine Harwood
(20)
,
Axel Hauschild
(21)
,
Ida Marie Heerfordt
(22)
,
Roland Kauffman
(23)
,
Nicole Kelleners Smeeths
(7, 8)
,
Aimilios Lallas
(24)
,
Celeste Lebbe
(25, 26)
,
Ulrike Leiter
(27)
,
Caterina Longo
(28)
,
Željko Mijušković
(29)
,
Giovanni Pellacani
(30)
,
Susana Puig
(6, 5, 4)
,
Philippe Saiag
(31, 32)
,
Mirna Šitum
(33)
,
Eggert Stockfleth
(34)
,
Carmen Salavastru
(19)
,
Alexander Stratigos
(35)
,
Iris Zalaudek
(36)
,
Claus Garbe
(27)
1
2MA -
Military Medical Academy [Belgrade, Serbia]
2 FPUAG - Fondazione Policlinico Universitario A. Gemelli [Rome]
3 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
4 University of Barcelona
5 ISC - Instituto de Salud Carlos III [Madrid]
6 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
7 MUMC - Maastricht University Medical Centre
8 Maastricht University [Maastricht]
9 FAU - Friedrich-Alexander Universität Erlangen-Nürnberg = University of Erlangen-Nuremberg
10 University Hospital Erlangen = Uniklinikum Erlangen
11 UNIVAQ - University of L'Aquila [Italy]
12 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
13 Kralovske Vinohrady University Hospital
14 Vilnius University [Vilnius]
15 ULB - Université libre de Bruxelles
16 Universität Witten/Herdecke
17 C2 - Centroderm Clinic [Wuppertal, Germany]
18 INCIT - Immunology and New Concepts in ImmunoTherapy
19 UMPCD - University of Medicine and Pharmacy “Carol Davila” Bucharest
20 QMUL - Queen Mary University of London
21 UKSH - University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein
22 Copenhagen University Hospital
23 Frankfurt University Hospital
24 Aristotle University of Thessaloniki
25 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
26 AP-HP - Hopital Saint-Louis [AP-HP]
27 Eberhard Karls Universität Tübingen = University of Tübingen
28 IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia
29 2MA - Medical Military Academy [Sofia, Bulgaria]
30 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
31 Hôpital Ambroise Paré [AP-HP]
32 BECCOH - Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie
33 University Hospital Sestre Milosrdnice
34 RUB - Ruhr University Bochum = Ruhr-Universität Bochum
35 NKUA - National and Kapodistrian University of Athens
36 Università degli studi di Trieste = University of Trieste
2 FPUAG - Fondazione Policlinico Universitario A. Gemelli [Rome]
3 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
4 University of Barcelona
5 ISC - Instituto de Salud Carlos III [Madrid]
6 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
7 MUMC - Maastricht University Medical Centre
8 Maastricht University [Maastricht]
9 FAU - Friedrich-Alexander Universität Erlangen-Nürnberg = University of Erlangen-Nuremberg
10 University Hospital Erlangen = Uniklinikum Erlangen
11 UNIVAQ - University of L'Aquila [Italy]
12 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
13 Kralovske Vinohrady University Hospital
14 Vilnius University [Vilnius]
15 ULB - Université libre de Bruxelles
16 Universität Witten/Herdecke
17 C2 - Centroderm Clinic [Wuppertal, Germany]
18 INCIT - Immunology and New Concepts in ImmunoTherapy
19 UMPCD - University of Medicine and Pharmacy “Carol Davila” Bucharest
20 QMUL - Queen Mary University of London
21 UKSH - University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein
22 Copenhagen University Hospital
23 Frankfurt University Hospital
24 Aristotle University of Thessaloniki
25 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
26 AP-HP - Hopital Saint-Louis [AP-HP]
27 Eberhard Karls Universität Tübingen = University of Tübingen
28 IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia
29 2MA - Medical Military Academy [Sofia, Bulgaria]
30 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
31 Hôpital Ambroise Paré [AP-HP]
32 BECCOH - Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie
33 University Hospital Sestre Milosrdnice
34 RUB - Ruhr University Bochum = Ruhr-Universität Bochum
35 NKUA - National and Kapodistrian University of Athens
36 Università degli studi di Trieste = University of Trieste
Lidija Kandolf
- Fonction : Auteur
- PersonId : 803205
- ORCID : 0000-0002-5221-5068
Ketty Peris
- Fonction : Auteur
- PersonId : 1247048
- ORCID : 0000-0003-1957-6600
Klara Mosterd
- Fonction : Auteur
- PersonId : 1362149
- ORCID : 0000-0002-9065-3050
Markus Heppt
- Fonction : Auteur
- PersonId : 1362150
- ORCID : 0000-0003-4603-1825
Maria Concetta Fargnoli
- Fonction : Auteur
- PersonId : 801076
- ORCID : 0000-0002-7249-2556
Petr Arenberger
- Fonction : Auteur
- PersonId : 803204
- ORCID : 0000-0002-4800-5877
Thomas Dirschka
- Fonction : Auteur
Brigitte Dreno
- Fonction : Auteur
- PersonId : 766608
- ORCID : 0000-0001-5574-5825
Ana‐maria Forsea
- Fonction : Auteur
- PersonId : 1184709
- ORCID : 0000-0002-1007-7883
Ida Marie Heerfordt
- Fonction : Auteur
- PersonId : 1362151
- ORCID : 0000-0002-6130-875X
Roland Kauffman
- Fonction : Auteur
- PersonId : 1362152
- ORCID : 0000-0002-1614-694X
Aimilios Lallas
- Fonction : Auteur
- PersonId : 803203
- ORCID : 0000-0002-7193-0964
Ulrike Leiter
- Fonction : Auteur
- PersonId : 1284762
- ORCID : 0000-0002-8019-1577
Caterina Longo
- Fonction : Auteur
- PersonId : 808164
- ORCID : 0000-0002-8218-3896
Giovanni Pellacani
- Fonction : Auteur
- PersonId : 794231
- ORCID : 0000-0002-7222-2951
- IdRef : 231946325
Susana Puig
- Fonction : Auteur
- PersonId : 766612
- ORCID : 0000-0003-1337-9745
Résumé
Abstract 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.