{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:55:11Z","timestamp":1792716911022,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Actinic keratosis (AK) is a common precancerous lesion of the skin that may be treated with chemical peelings. Despite their long\u2010standing usage and clinical experience, no evidence\u2010based recommendation regarding the efficacy and safety of chemical peelings for AK exists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To systematically review and synthesize the current knowledge on chemically exfoliative peelings as interventions for AK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a systematic literature research in Medline, Embase and CENTRAL and hand\u2010searched pertinent trial registers for eligible records until 5 August 2019. Results from individual studies were pooled using a random\u2010effects model or described in a qualitative synthesis. The risk of bias was estimated with the tools provided by the Cochrane Collaboration (randomized and non\u2010randomized trials) and the Evidence Project (single\u2010arm trials).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Four randomized controlled trials, two non\u2010randomized controlled trials and two single\u2010arm studies with a total sample size of\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0170 patients were included. Trichloroacetic acid (TCA) plus Jessner\u2019s solution showed significantly lower participant complete clearance (RR 0.36, 95% CI: 0.14\u20130.90, two studies,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03) and lower lesion clearance (RR 0.92, 95% CI: 0.85\u20130.99, one study,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03) compared to 5\u2010fluorouracil (5\u2010FU) 5% cream. TCA as monotherapy showed lower lesion complete clearance (RR 0.75, 95% CI: 0.69\u20130.82, two studies,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a07%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and lower mean lesion reduction per patient compared to conventional photodynamic therapy (cPDT) (MD \u221220.48, 95% CI: \u221231.55 to \u22129.41, two studies,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a043%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.0003). Pain was more pronounced in patients treated with cPDT in comparison with TCA (MD \u22121.71 95% CI: \u22123.02 to \u22120.41, two studies,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a055%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01). In the single\u2010arm studies, 5\u2010FU plus glycolic acid showed 92% lesion clearance and phenol peeling 90.6% participant complete clearance. All studies showed a high risk for bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Future high\u2010quality studies and a standardization of peeling protocols are warranted to determine the value of chemical peelings in the treatment of AK.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.16844","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T17:15:25Z","timestamp":1596474925000},"page":"641-649","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Chemical peelings for the treatment of actinic keratosis: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9008-0088","authenticated-orcid":false,"given":"T.","family":"Steeb","sequence":"first","affiliation":[{"name":"Department of Dermatology Universit\u00e4tsklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.A.T.","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Dermatology Universit\u00e4tsklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1940-5115","authenticated-orcid":false,"given":"A.","family":"Wessely","sequence":"additional","affiliation":[{"name":"Department of Dermatology Universit\u00e4tsklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.G.","family":"Wiest","sequence":"additional","affiliation":[{"name":"Private Practice of Dermatology Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9627-2179","authenticated-orcid":false,"given":"L.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology Ruhr\u2010University Bochum Germany"},{"name":"Institute of Dermatopathology MVZ Corius DermPathBonn Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0229-8931","authenticated-orcid":false,"given":"C.","family":"Berking","sequence":"additional","affiliation":[{"name":"Department of Dermatology Universit\u00e4tsklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-1825","authenticated-orcid":false,"given":"M.V.","family":"Heppt","sequence":"additional","affiliation":[{"name":"Department of Dermatology Universit\u00e4tsklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg (FAU) Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,18]]},"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":"10.1002\/cncr.24284"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15107"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/ddg.14048","article-title":"S3 guideline for actinic keratosis and cutaneous squamous cell carcinoma \u2010 short version, part 1: diagnosis, interventions for actinic keratoses, care structures and quality\u2010of\u2010care indicators","volume":"18","author":"Heppt MV","year":"2020","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2009.03409.x"},{"key":"e_1_2_6_8_1","first-page":"e123\u201330","article-title":"Preferred reporting items for systematic reviews and meta\u2010analyses: the PRISMA Statement","volume":"3","author":"Moher D","year":"2009","journal-title":"Open Med"},{"key":"e_1_2_6_9_1","unstructured":"HigginsJPT ThomasJ ChandlerJ CumpstonM LiT PageMJ WelchVA eds.Cochrane Handbook for Systematic Reviews of Interventions version 6.0. 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