光化性角化病 Actinic keratosis - PubMed 文献(第 5 页)
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光化性角化病 的 PubMed 搜索结果(第 5 页)
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Comparing efficacy and safety of potassium hydroxide 5% solution with 5-fluorouracil cream in patients with actinic keratoses: a randomized controlled trial. 比较5%氢氧化钾溶液与5-氟尿嘧啶乳膏在光化性角化病患者中的疗效和安全性：一项随机对照试验。
Actinic keratosis (AK) is a pre-cancerous skin lesion, associated with development of squamous cell carcinoma. Current treatment options are limited. To compare the efficacy and safety of topical 5-fluorouracil cream (5-FU) and potassium hydroxide 5% (KOH) in the treatment of AK. Eighteen patients with AK applied KOH solution or 5-FU on each side of their scalp/face, randomly. The efficacy and safety of these treatments were compared. Thirteen (118 lesions) and ten (83 lesions) patients were successfully followed for one and three months, respectively. After one month, KOH showed a better clinical response (81% vs. 58%; -value = 0.007) and dermoscopic response (KOH, 65% vs. 5-FU, 46%; -value = 0.04); while no differences were noted after three months (clinical response, 83% vs.70%, -value = 0.1; dermoscopic response, 76% vs. 59%, -value = 0.1). No significant differences in the recurrence rate of the lesion between the two groups were noted at the end of the third month (-value = 0.5). Regarding the safety of the treatments, the risk of developing erythema, scaling, sand swelling was higher in 5-FU group (-value < 0.0001, for all), while more patients in KOH group had erosion and ulcer (-value < 0.001 for both). KOH was up to 96% less expensive than 5-FU. Low number of patients and short-term follow-up limited the analysis. KOH solution offers a faster and less expensive resolution of AK lesions than does 5-FU. IRCT20180909040978N1.
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Emerging drugs for actinic keratosis. 光化性角化病的新兴药物。
Actinic keratoses (AK) represent a worldwide problem with continuously increasing incidence. AK are characterized by a proliferation of atypical keratinocytes limited to the epidermis, but they may develop into invasive squamous cell carcinoma. In this regard, novel treatment modalities have been developed that allow treatment of the whole actinically damaged field. An overview about current treatment modalities for AK including, among others, their mechanism of action, application scheme and common side effects. Furthermore, recent developments in the field are described and future aspects are discussed. The reader of this review will be informed about all current treatment modalities for AK. Furthermore, the reader will gain knowledge about ongoing research in this field and novel topical drugs for the treatment of AK. Many treatment modalities are available for the treatment of AK. Recent developments have focused on the management of the whole actinically damaged field. In this regard, several topical drugs have been approved for AK, differing in clearance rates, side effects, application and cost. Research is continuing aiming in the development of the "ideal" treatment of AK which combines high clearance rates with few side effects, short treatment duration and low costs.
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Glutathione S-Transferase Theta 1 / Mu 1 Null Genotype and Risk of Development of Actinic Keratosis in Pakistani Population. 谷胱甘肽S-转移酶θ1/μ1缺失基因型与巴基斯坦人群光化性角化病发生风险。
To assess the frequency and association of Glutathione S-Transferase Theta 1 and Glutathione S-Transferase Mu 1 null genotypes in development of actinic keratosis (AK) in a group of Pakistani population. Case-control analytical study. Department of Biochemistry, Islamic International Medical College, Rawalpindi in collaboration with Department of Dermatology, Railway Hospital and Rural Health Center, District Health Office, Rawalpindi from September 2018 to September 2019. Methodology: A total of 86 participants were included in this study with 27 biopsy proven cases of AK and 59 matched controls. Blood samples were collected after obtaining written informed consent; and DNA was extracted by Chelex™ method. Multiplex PCR (M-PCR) was done to find respective allelic frequencies of GSTM1 and GSTT1 genes in both cases and controls. Results: Mean age of participants in cases and controls was 62.93 ±10.29 years and was 61.42 ±9.96 years, respectively. There were 18 males (66.7%) and 9 females (33.3%); and 43 males (72.9%) and 16 females (27.1%) in cases and controls, respectively. There was a significant association of GSTT1 null genotype with AK (OR: 2.72, 95% CI: 1.05-7.05, p = 0.037). There was a positive correlation between GSTT1 null genotype and AK (r = 0.225, p = 0.037). GSTT1 null genotype has a significant association for AK development in the studied Pakistani population. Key Words: Actinic keratosis, Glutathione S-Transferase Mu 1, Glutathione S-Transferase Theta 1, Polymerase chain reaction, Squamous cell carcinoma.
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The reliability of counting actinic keratosis. 计数光化性角化病的可靠性。
Many epidemiological studies and clinical trials have been performed concerning actinic keratoses. The most eligible endpoint in the majority of articles is counting of actinic keratoses before and after treatments, nevertheless some authors support that this is not a reliable form of evaluation. The aim of this study was to evaluate the actinic keratoses counting by various raters and suggest approaches to increase the reliability. Cross-sectional study: forty-three patients were evaluated by four raters (inter- and intra-rater assessment) on the face and forearms. The mean actinic keratoses counts on the face and forearms were 7.7 and 9.1. The overall agreement among the raters for the facial and forearm actinic keratoses was 0.74 and 0.77. The intra-rater assessment showed high rates of agreement for the face (ICC=0.93) and forearms (ICC=0.83). Higher agreement occurred when counting up to five lesions. Four raters led to increased measurement variability and loss of reliability. Higher rates of agreement may be achieved with small number of lesions, limitation and/or segmentation of body areas to reduce their number, in AK prevention designs, are strategies that may lead to a greater reliability of these measurements.
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Assessing the Dermal Epidermal Junction of Hyperkeratotic Actinic Keratoses via Line-Field Confocal Optical Coherence Tomography. 通过线场共焦光学相干断层扫描评估角化过度型光化性角化病的真表皮交界。
Actinic keratoses (AKs) are ultraviolet (UV)-induced skin lesions that may progress to invasive squamous cell carcinoma. Hyperkeratotic AKs hinder line-field confocal optical coherence tomography (LC-OCT) imaging, limiting assessment of the dermal-epidermal junction (DEJ) and PRO-score, a histopathological index of dermal invasion. The aim of this study was to evaluate whether moisturization improves DEJ visualization and PRO-score evaluation in hyperkeratotic AKs using LC-OCT. Fifty-nine hyperkeratotic AKs were randomized to receive either 20-min tap water occlusion or 20% salicylic acid ointment (SAO). LC-OCT scans were taken before and after treatment. DEJ visibility, PRO-score (0-3), and confidence in PRO assignment (cPRO) were rated by blinded evaluators. DEJ visibility significantly increased posttreatment (from 39.0% to 86.4%, p = 0.015), with no significant difference between water and salicylic acid ointment (SAO). Confidence in PRO-scoring also improved (p < 0.001), and 39.1% of lesions with initial scores were reclassified. G2 AKs had higher DEJ visibility than G3 both before and after treatment. Moisturization enhances LC-OCT evaluation of hyperkeratotic AKs, improving DEJ visualization and diagnostic confidence.
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Liquid nitrogen cryotherapy effectively and safely improves response of thick actinic keratoses lesions by 5-aminolevulinic acid-based photodynamic therapy: A randomized, prospective, single-blind trial. 液氮冷冻疗法有效且安全地改善厚型光化性角化病病变对基于5-氨基酮戊酸的光动力疗法的反应：一项随机、前瞻性、单盲试验。
Actinic keratoses (AK) may progress into squamous cell carcinoma. Many combination therapies were used to improve the clearance rate. However, there are limited studies on the efficacy and safety of lesion-directed Liquid nitrogen cryotherapy combined with field-directed photodynamic therapy (PDT). This study is aimed to determine the efficacy and safety of Liquid nitrogen cryotherapy combined with PDT in Chinese patients with actinic keratosis. A total of 61 patients with AK were selected at the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College between August 2018 and August 2023. They were randomly divided into PDT plus Liquid nitrogen cryotherapy group (LN-PDT) and control PDT group (C-PDT) with 30 patients and 31 patients, respectively. 27 patients in the LN-PDT group and 28 patients in the C-PDT group completed the clinical sessions. Efficacy, adverse effects, and cosmetic outcomes were recorded and compared between the two groups. 3 months after the final treatment, the clearance rates for total AK lesions were 97.4 % (449/461) in the LN-PDT group and 93.4 % (456/488) in the C-PDT group (P < 0.05). For grade I AK lesions, the clearance rates were 99.2 % (234/237) for the LN-PDT group and 98.3 % (237/241) for the C-PDT group (P >0.05). For grade II lesions, the clearance rates were 97.5 % (156/160) for the LN-PDT group and 91.9 % (172/186) for the CPDT group (P < 0.05). For grade III lesions, the clearance rates of the LN-PDT and C-PDT groups were 87.5 % (58/64) and 78.7 % (47/61), respectively (P < 0.05). The two groups had no significant differences in pain, erythema, edema, hyperpigmentation and scarring. Cosmetic outcomes mainly were excellent or good in both groups with no significant difference. Liquid nitrogen cryotherapy combined with PDT showed higher efficacy on grade II and grade III AK lesions than PDT alone. The two groups have similar adverse effects and cosmetic outcomes.
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Assessing the influence of actinic keratosis on patients' quality of life: the AKQoL questionnaire. 评估光化性角化病对患者生活质量的影响：AKQoL问卷。
Limited knowledge is available regarding quality of life in patients with actinic keratosis (AK). To develop and validate a disease-specific questionnaire - the Actinic Keratosis Quality of Life questionnaire (AKQoL) - to assess the quality of life of patients with AK. Based on an extensive literature search and patient interviews, the AKQoL was developed in a stepwise approach. An initial mega-questionnaire was composed and subsequently shortened based on statistical differences between patients and controls. A test-retest was done to establish the reliability and to refine the items further. Rasch analyses were performed on the final questionnaire. Initially, 175 items were tested in a mega-questionnaire. The questionnaires were sent out twice and statistical analyses were made, reducing the number of questions to 18 and 10, respectively. Subsequent inter-item correlations showed that one item had only a weak correlation to the rest of the scale. This was confirmed by the Rasch model and by internal consistency as evaluated by Cronbach's coefficient alpha. Only one item was found to provide a small sex difference. A Bland-Altman plot showed excellent reliability. Items are scored on a standard 4-point Likert scale and summarized in a total score of maximum 27 points. A higher score indicates greater quality of life impairment. A nine-item questionnaire for patients with AK was developed. The AKQoL has three domains covering emotions, function and control and one single global item. The questionnaire's scale structure, the content and face validity, and the reliability have been established.
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A randomized comparative study of tolerance and satisfaction in the treatment of actinic keratosis of the face and scalp between 5% imiquimod cream and photodynamic therapy with methyl aminolaevulinate. 5%咪喹莫特乳膏与甲基氨基乙酰丙酸光动力疗法治疗面部和头皮光化性角化病的耐受性和满意度随机比较研究。
Photodynamic therapy (PDT) and imiquimod are two excellent treatments for actinic keratosis but are often not well tolerated by patients. To ascertain which treatment is better tolerated and which produces greater patient satisfaction. A secondary objective was to determine the factors related to the patient's tolerance to each treatment. Patients with at least five actinic keratosis lesions on the face and scalp were selected. The patients were randomized to receive treatment with PDT with methyl aminolaevulinate or treatment with imiquimod. Tolerance, satisfaction and predisposition to repeat the treatment were evaluated. Most patients exhibited good or acceptable tolerance to both PDT and imiquimod treatment. There was a higher percentage of patients treated with PDT (93%) who were very satisfied compared with imiquimod (62%) (P=0·004). Most patients treated with either one of the two options would repeat the same treatment. No significant relationship was found between age, sex, working time exposed to the sun, phototype and hair colour and the tolerance to both treatments. Both PDT and imiquimod are treatments that are generally well tolerated. While both treatments provide a high level of satisfaction, PDT appears to be slightly superior in this regard.
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Medical gas plasma modulates in vitro keratinocyte redox signaling and secretory profiles in actinic keratosis and squamous cell carcinoma. 医用气体等离子体调节光化性角化病和鳞状细胞癌中体外角质形成细胞氧化还原信号传导和分泌谱。
Actinic keratosis (AK) and squamous cell carcinoma (SCC) represent progressive keratinocyte disorders in which oxidative stress and dysregulated signaling contribute to disease pathology. Medical gas plasma is an emerging therapeutic tool that generates reactive oxygen and nitrogen species capable of modulating cellular function. Here, we evaluated a newly developed helium multijet plasma device for its potential to treat precancerous and cancerous keratinocyte diseases. To cover the entire keratinocyte carcinogenesis process, in vitro models of normal keratinocytes (HaCaT), AK (HT-297.T), and SCC (A431) were used. A 2-minute plasma treatment produced moderate levels of reactive species in the liquid phase, inducing intracellular oxidation and decreasing viability in a cell type-dependent manner, being most effective in SCC. Plasma exposure modulated stress- and survival-associated signaling pathways and reshaped the secretion of growth factors and pro-inflammatory chemokines, with AK cells showing the most pronounced responses. These findings demonstrate that plasma-generated oxidants act as signaling mediators that can fine-tune keratinocyte behavior without overt cytotoxicity in vitro, supporting the potential of controlled plasma exposure as a therapeutic strategy for actinic keratosis and other skin cancers.
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Physician perceptions and experience of current treatment in actinic keratosis. 医生对光化性角化病当前治疗的认知和经验。
Topical therapy is important in the treatment of actinic keratosis (AK), a major risk factor for, and early development stage of, squamous cell carcinoma. Despite this, research addressing the limitations and challenges associated with topical field therapy in actinic keratosis is lacking. The aim of this study was to highlight the challenges associated with maximizing compliance in patients receiving topical AK therapy and to investigate real-world experience with currently available topical therapies including perceptions of adherence and persistence. A 45-min online survey was developed and completed by physicians in eight countries. All had previously prescribed topical AK therapy and ≥1 other treatment. Physicians' consensus was summarized as overall agreement/disagreement from ≥70% of respondents (≥60% for case-specific questions). More than 70% of the 427 respondents agreed that topical field therapy is essential and had concerns that lengthy treatments and local skin reactions caused non-adherence/persistence. More than 90% of physicians would preferentially prescribe the shortest duration treatment to such patients. The research clarifies the challenges associated with prescribing topical AK therapy and highlights that short treatment duration and rapid clearance of skin reactions are key considerations for physicians. This provides a basis for the generation of recommendations for improving the real-world efficacy of topical therapy.