{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:48:04Z","timestamp":1790023684585,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study describes a prospective, multicentre, randomized controlled, open\u2010label study with three arms aimed at studying the differences between: [Cnt], self\u2010administered sun protection; [T], topical treatment; and [TO], topical + oral treatment; for the management of Actinic Keratosis (AK) in a cohort of subjects of advanced age displaying severe actinic damage (SAD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Treatments administered to groups [T] and [TO] had a common component, which is a botanical extract, Fernblock, with demonstrated photoprotective activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 131 subjects were distributed randomly in the three groups, and followed up clinically at three separate time points, beginning of the study (<jats:italic>t<\/jats:italic>\u00a0=\u00a00) and after 6 and 12\u00a0months. Analysis of clinical data and examination using reflectance confocal microscopy (RCM) revealed that group [T] and [TO] displayed decreased clinical AK and field cancerization parameters, including the number of new lesions, and reduced the need for additional interventions in these patients. RCM revealed normalization of the keratinocyte layer. Improvements in AK and field cancerization parameters were greatest in the group [TO], suggesting that topical and oral photoprotection improves the clinical and anatomical outcome compared to control conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of topical and oral immune photoprotection provides an advantage compared to topical photoprotection alone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/phpp.12870","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T14:39:46Z","timestamp":1678372786000},"page":"384-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The combination of oral and topical photoprotection with a standardized <i>Polypodium leucotomos<\/i> extract is beneficial against actinic keratosis"],"prefix":"10.1111","volume":"39","author":[{"given":"Giovanni","family":"Pellacani","sequence":"first","affiliation":[{"name":"Dermatology Clinic University La Sapienza  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketty","family":"Peris","sequence":"additional","affiliation":[{"name":"Dermatology Clinic Catholic University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Ciardo","sequence":"additional","affiliation":[{"name":"Dermatology Clinic University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pezzini","sequence":"additional","affiliation":[{"name":"Dermatology Clinic University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Tambone","sequence":"additional","affiliation":[{"name":"Dermatology Clinic Catholic University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Farnetani","sequence":"additional","affiliation":[{"name":"Dermatology Clinic University of Modena and Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Longo","sequence":"additional","affiliation":[{"name":"Ospedale S. Maria Nuova \u2013 IRCCS  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Chello","sequence":"additional","affiliation":[{"name":"Dermatology Clinic University La Sapienza  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialties Alcal\u00e1 de Henares University  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-015-0070-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S31930"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000366525"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12102"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0366-077X.2003.05625.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12848"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910460303"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13180"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14652"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.201085"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15091"},{"key":"e_1_2_8_13_1","first-page":"651","article-title":"Polypodium leucotomos extract as an antioxidant agent in the therapy of skin disorders","volume":"102","author":"Gonzalez S","year":"1994","journal-title":"J Invest Dermatol"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.1996.tb00175.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0781.1997.tb00108.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/antiox10121961"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2353\/ajpath.2009.090351"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.2007.00684.x"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphotobiol.2005.11.005"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.06.027"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16559"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2710"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13215"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14359"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2011.08.021"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0846.2012.00623.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.04.017"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000425"},{"issue":"4","key":"e_1_2_8_29_1","article-title":"Long\u2010term efficacy of a new medical device containing Fernblock and DNA repair enzyme complex in the treatment and prevention of cancerization field in patients with actinic keratosis","volume":"10","author":"Unamuno BB","year":"2019","journal-title":"J Clin Exp Dermatol Res"}],"container-title":["Photodermatology, Photoimmunology &amp; Photomedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phpp.12870","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/phpp.12870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T07:53:43Z","timestamp":1692345223000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/phpp.12870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,31]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/phpp.12870"],"URL":"https:\/\/doi.org\/10.1111\/phpp.12870","archive":["Portico"],"relation":{},"ISSN":["0905-4383","1600-0781"],"issn-type":[{"value":"0905-4383","type":"print"},{"value":"1600-0781","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,31]]},"assertion":[{"value":"2022-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}