{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T03:11:52Z","timestamp":1771902712949,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sequential treatment of actinic keratosis (<jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>) and cancerization field with cryotherapy and ingenol mebutate (<jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>) is widely used in clinical practice, however, the order of application of sequential treatment has not been examined yet.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare different sequential treatments of IM and cryotherapy in <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> and to monitor cure rates and local skin reactions (<jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content>) through reflectance confocal microscopy (<jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> were treated with <jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content> and cryotherapy. Group A received treatment with <jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content> before cryotherapy, and group B patients were firstly treated with cryotherapy and secondly <jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> evaluation of epidermal dysplasia and <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content> was performed prior to the first treatment (Week 0), before the second treatment (Week 2), and one month and two months after initial assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 26 patients \u2013 14 patients in group A and 12 patients in group B. In both groups, significant improvement in epidermal dysplasia <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> parameters between the first and last visit was observed. Regarding <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content> parameters, group A presented fewer <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content> parameters than group B on the second visit. This difference was present even if comparison was made between the third visit of group A and the second visit of group B.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both sequences of treatment are effective, but <jats:styled-content style=\"fixed-case\">IM<\/jats:styled-content> treatment before cryotherapy is recommended because of the lower <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content>. This probably decreases patient discomfort and improves compliance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.14164","type":"journal-article","created":{"date-parts":[[2018,8,2]],"date-time":"2018-08-02T00:12:48Z","timestamp":1533168768000},"page":"1178-1181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Sequential treatment of actinic keratosis with cryotherapy and ingenol mebutate: reflectance confocal microscopy monitoring of efficacy and local skin reaction"],"prefix":"10.1111","volume":"57","author":[{"given":"Paola","family":"Pasquali","sequence":"first","affiliation":[{"name":"Dermatology Department Valls Piu Hospital Tarragona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gonzalo","family":"Segurado\u2010Miravalles","sequence":"additional","affiliation":[{"name":"Dermatology Department Ram\u00f3n y Cajal Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvador","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Medicine y Medical Specialities Alcal\u00e1 de Henares University Madrid Spain"},{"name":"Dermatology Department Memorial Sloan Kettering Cancer Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14151"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14092"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13180"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-43939-5_16"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.105565"},{"key":"e_1_2_7_7_1","first-page":"171","article-title":"Clinical applicability of in vivo reflectance confocal microscopy in dermatology","volume":"147","author":"Ulrich M","year":"2012","journal-title":"G Ital Dermatol E Venereol Organo Uff Soc Ital Dermatol E Sifilogr"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2607"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13304"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-016-0094-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14968"},{"key":"e_1_2_7_12_1","first-page":"1181","article-title":"Biological effects of ingenol mebutate gel in moderate to severe actinic fields assessed by reflectance confocal microscopy: A phase I study","volume":"15","author":"Ulrich M","year":"2016","journal-title":"J Drugs Dermatol"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fijd.14164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijd.14164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T18:32:32Z","timestamp":1694975552000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijd.14164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1111\/ijd.14164"],"URL":"https:\/\/doi.org\/10.1111\/ijd.14164","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8]]},"assertion":[{"value":"2018-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}