{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:12:04Z","timestamp":1791994324540,"version":"4.4.0"},"reference-count":67,"publisher":"Wiley","issue":"S5","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"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":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Actinic keratoses (AK) are common skin lesions associated with chronic exposure to sun. They are believed to be precursors of malignancy as they potentially may progress to invasive squamous cell carcinomas. The goal of current therapies is to reduce the number of AK and to prevent future cancer development. This review aims at providing an overview of the hallmarks of AK and skin field cancerization. We discuss epidemiology trends, risk factors and the state of the art and evidence of the current treatments. We review key figures of AK prevalence from different countries with regard to skin cancer risk and the associated economic burden of AK. We discuss the mutational status in AK lesions and the difficulties encountered by clinicians in evaluating AK visible and invisible lesions, referring to the concept of field cancerization. Based on a systematic literature review, we further evaluate the available treatment options. The presence of subclinical skin alterations in the periphery of visible AK lesions has gained a particular attention as those non\u2010visible lesions are known to contain the same genetic changes as those found in the AK lesions themselves, prompting the concept of \u2018field cancerization\u2019. Therefore, AK treatment guidelines now recognize the importance of treating the field in patients with AK. A recent systematic literature review and network meta\u2010analysis showed that 5\u2010FU interventions were associated with the best efficacy and a satisfactory acceptability profile compared with other field\u2010directed therapies used in the treatment of AK. Although AK are considered quite common, they lack an accurate descriptive definition and conclusive epidemiologic data. Limited public awareness is a barrier to early and effective treatment, including prevention strategies. While different treatment options are available, there is still a limited understanding of long\u2010term outcomes of treatment as measured by recurrence of cancer prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.19559","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T09:09:54Z","timestamp":1719392994000},"page":"3-11","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Actinic keratosis: Current challenges and unanswered questions"],"prefix":"10.1111","volume":"38","author":[{"given":"Josep","family":"Malvehy","sequence":"first","affiliation":[{"name":"Hospital Clinic de Barcelona, IDIBAPS, and Spain &amp; Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Stratigos","sequence":"additional","affiliation":[{"name":"Department of Dermatology &amp; Venereology Andreas Sygros Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1631-5192","authenticated-orcid":false,"given":"Martine","family":"Bagot","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Saint\u2010Louis Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris, and Human Immunology, Pathophysiology and Immunotherapy, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U976 Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eggert","family":"Stockfleth","sequence":"additional","affiliation":[{"name":"Department of Dermatology Ruhr University of Bochum  Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-4589","authenticated-orcid":false,"given":"Khaled","family":"Ezzedine","sequence":"additional","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Henri Mondor, EA EpiDermE UPEC\u2010Universit\u00e9 Paris\u2010Est Cr\u00e9teil  Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Delarue","sequence":"additional","affiliation":[{"name":"Pierre Fabre Dermatologie  Lavaur France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1067\/mjd.2000.103343","article-title":"Clinical presentation of actinic keratoses and squamous cell carcinoma","volume":"42","author":"Moy RL","year":"2000","journal-title":"J Am Acad Dermatol"},{"issue":"3","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.1365-2133.2007.07860.x","article-title":"Actinic keratosis is an early in\u00a0situ squamous cell carcinoma: a proposal for reclassification","volume":"156","author":"R\u00f6wert\u2010Huber J","year":"2007","journal-title":"Br J Dermaol"},{"key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1016\/j.jaad.2012.09.053","article-title":"Pathobiology of actinic keratosis: ultraviolet\u2010dependent keratinocyte proliferation","volume":"68","author":"Berman B","year":"2013","journal-title":"J Am Acad Dermatol"},{"key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/bjd.12420","article-title":"The natural history of actinic keratosis: a systematic review","volume":"169","author":"Werner RN","year":"2013","journal-title":"Br J Dermatol"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-09722-8","article-title":"Spontaneous regression rates of actinic keratosis: a systematic review and pooled analysis of randomized controlled trials","volume":"12","author":"Steeb T","year":"2022","journal-title":"Sci Rep"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"2523","DOI":"10.1002\/cncr.24284","article-title":"Department of Veteran Affairs Topical Tretinoin Chemoprevention Trial Group. 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