{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:56:09Z","timestamp":1781272569384,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Actinic Keratosis (AK) has the potential to progress into malignant cancer, thus necessitating timely and effective treatment. Despite several existing therapies, there is still a need for effective, well\u2010tolerated therapeutic options, especially in the early treatment of patients with few isolated lesions in primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the efficacy and safety of potassium hydroxide (KOH) 5% solution in comparison to diclofenac 3% gel and placebo for the treatment of mild\u2010to\u2010moderate AK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this randomized controlled trial, patients with mild or moderate AK applied KOH or placebo solution double\u2010blinded twice daily for 28\u2009days, followed by a 28\u2010day off\u2010treatment phase (1 treatment cycle) for up to three treatment cycles or until treatment success. In a third arm, diclofenac was applied twice daily for 60\u2009days and evaluated investigator\u2010blinded. The primary endpoint was treatment success, defined as complete clearance (CC) of all initially present AK lesions per patient at the end of treatment (EOT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 631 patients were enrolled. Treatment success was achieved by 45.2% of patients treated with KOH, compared to 23.8% and 22.9% with diclofenac and placebo, respectively. Similarly, complete remission rates for individual lesions were higher with KOH (65.0%) than with diclofenac (45.9%) or placebo (39.9%). KOH showed a faster onset of action, with higher CC rates already after 1\u2009month compared to diclofenac (16.0% vs. 9.2%) and converging efficacies after 6\u2009months. Most adverse reactions were mild and localized, with comparable tolerability of KOH and diclofenac.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>KOH 5% solution proved superior to placebo and, when compared to diclofenac 3% gel, demonstrated significantly higher efficacy at EOT, as well as faster onset of action with comparable long\u2010term efficacy and tolerability. KOH 5% solution is a valuable addition to the available treatment options for lesion\u2010directed therapy in patients with mild\u2010to\u2010moderate AK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinicaltrials.gov Identifier<\/jats:title>\n                    <jats:p>NCT 04552327.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70069","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:25:08Z","timestamp":1758803108000},"page":"1050-1058","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>KOH<\/scp>\n                    5% solution versus diclofenac 3% for the treatment of actinic keratosis \u2013 Results from a three\u2010armed\n                    <scp>RCT<\/scp>"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8970-8256","authenticated-orcid":false,"given":"U.","family":"Reinhold","sequence":"first","affiliation":[{"name":"MVZ Dermatologisches Zentrum Bonn GmbH  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Leitz","sequence":"additional","affiliation":[{"name":"Hautarztpraxis Dr. Leitz Und Kollegen  Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Dominicus","sequence":"additional","affiliation":[{"name":"Hautzentrum D\u00fclmen, ProDerma Studieninstitut  D\u00fclmen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. L.","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Hautarztzentrum Hamm  Hamm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Dirschka","sequence":"additional","affiliation":[{"name":"Centroderm GmbH  Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Popp","sequence":"additional","affiliation":[{"name":"Dermazentrum Augsburg  Augsburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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