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Treating Actinic Keratosis In Primary Care
This month’s research article is a scholarly review from the British Journal of Dermatology. The topic of the article is actinic keratosis (AK), which is such a common condition – and $1 billion is spent in the US each year treating it.
I picked this for two reasons. Firstly, it shows how little we know. There is no agreed definition of actinic keratosis, we don’t know how frequent transition to SCC is, and we don’t really know (in a comparative sense) which treatments are better! If you are interested in a comprehensive overview of AK – this paper is worth reading.
The second reason I picked the paper is Table 5 – a summary of available treatment options. What this shows is that most options work reasonably well and that what we recommend for most GPs in Australia makes sense. That is :
1) cryotherapy for individual spot lesions,
2) 5 FU / Efudix for field treatment to the affected area, and
3) curettage for those really thick and crusty lesions that need physical removal.
AK treatment needs careful consideration and thought – not just a quick squirt of cryo!
Professor David Wilkinson
Read more from Professor David Wilkinson on recent research:
- Mohz Micrographic Surgery vs. Wide Local Excision for Melanoma In Situ
- Treating Melanoma in Primary Care