{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:43:46Z","timestamp":1769762626400,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005972","name":"Deutsche Krebshilfe","doi-asserted-by":"publisher","award":["70112351"],"award-info":[{"award-number":["70112351"]}],"id":[{"id":"10.13039\/501100005972","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Actinic keratoses (AK) are common precancerous lesions of the skin. Numerous interventions exist for the treatment of AK, including lesion\u2010 and field\u2010directed approaches. In daily practice, different treatment modalities are often combined to maximize clearance rates. However, whether a combination therapy is preferable to monotherapy in terms of efficacy and safety has been subject of intense debate. In this review, we summarize the current knowledge on the efficacy and safety of local combination therapies for the treatment of patients with AK. Combination approaches of cryosurgery followed by photodynamic therapy (PDT), laser\u2010assisted PDT, PDT in combination with topical interventions and microneedling\u2010assisted PDT have shown slightly better efficacy results with similar tolerability compared to the respective monotherapy. However, the individual usage of combination therapies should be checked on a case\u2010by\u2010case basis and take into account individual patient\u2010 and lesion\u2010specific aspects as more resources are needed and because the individual monotherapies are already highly effective.<\/jats:p>","DOI":"10.1111\/jdv.15998","type":"journal-article","created":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T08:57:26Z","timestamp":1570352246000},"page":"727-732","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["The more the better? An appraisal of combination therapies for actinic keratosis"],"prefix":"10.1111","volume":"34","author":[{"given":"T.","family":"Steeb","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Wessely","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"Leiter","sequence":"additional","affiliation":[{"name":"Department of Dermatology Center for Dermatooncology University Hospital T\u00fcbingen T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.E.","family":"French","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Berking","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.V.","family":"Heppt","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy University Hospital LMU Munich Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.103342"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.103343"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.07860.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14652"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24284"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12420"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2692"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13180"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14375"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-4725.2000.99197.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12847"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17435"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.06.006"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08882.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.1997.tb08549.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07484.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.2007.00276.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0516-9"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.09.021"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5268"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17096"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15098"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000589"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13449"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12974"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15459"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/dsu.12233"},{"key":"e_1_2_6_30_1","first-page":"1072","article-title":"Microneedling prior to Levulan PDT for the treatment of actinic keratoses: A split\u2010face, blinded trial","volume":"15","author":"Spencer JM","year":"2016","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2017.0849"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15116"},{"key":"e_1_2_6_33_1","unstructured":"NCT02632110.Microneedle Lesion Preparation Prior to Aminolevulinic Acid Photodynamic Therapy (ALA\u2010PDT) for AK on Face. 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