{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T12:02:34Z","timestamp":1769342554091,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T00:00:00Z","timestamp":1593129600000},"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":["Skin Research and Technology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Actinic keratosis (AK) incidence is increasing. Due to the risk of progression to squamous cell carcinoma, early detection and treatment are essential. The method stated in the European Consensus is cryotherapy, but there is no standard protocol defined for better results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare two different cryotherapy protocols for AK using reflectance confocal microscopy (RCM) as a noninvasive imaging method for evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A self\u2010controlled clinical trial was proposed to compare the efficacy of cryotherapy in two different application protocols. Grade II AKs in the forearms were submitted to freezing and thawing time of 10\u00a0seconds for 1 cycle (group A) or 2 cycles (group B). At baseline and 4\u00a0weeks after treatment, the same dermatologists assessed RCM evaluation (thickness of horny layer, parakeratosis, dyskeratosis, atypia in spinous layer, fibrosis, and presence of inflammatory cells in epidermis and dermis).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We examined 24 AK lesions in each group. Statistical evaluation of the results evidenced superior response after 2 cycles of cryotherapy in parakeratosis and number of inflammatory cells in epidermis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both protocols are effective in clearing clinical AK. Two cycles are not generating more side effects (fibrosis) and could reduce the risk of recurrence (better \u201cclearance\u201d of parakeratosis).<\/jats:p><\/jats:sec>","DOI":"10.1111\/srt.12889","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T10:29:43Z","timestamp":1593253783000},"page":"876-882","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Reflectance confocal microscopy in actinic keratosis\u2014Comparison of efficacy between cryotherapy protocols"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-027X","authenticated-orcid":false,"given":"Amanda Nascimento Cavalleiro Macedo","family":"Mota","sequence":"first","affiliation":[{"name":"Dermatology Department State University of Rio de Janeiro (UERJ) Rio de Janeiro Brazil"},{"name":"Dermatology Departament Central Aeronautics Hospital (HCA) Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0823-5731","authenticated-orcid":false,"given":"Nathalie","family":"De Carvalho","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia (UNIMORE) Modena Italy"},{"name":"Dermatology Department Federal University of the State of Rio de Janeiro (UNIRIO) Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Pellacani","sequence":"additional","affiliation":[{"name":"Dermatology Department University of Modena and Reggio Emilia (UNIMORE) Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula Carolina Pessanha","family":"de Faria","sequence":"additional","affiliation":[{"name":"Dermatology Department State University of Rio de Janeiro (UERJ) Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Fernandes","family":"Melo","sequence":"additional","affiliation":[{"name":"Dermatology Department State University of Rio de Janeiro (UERJ) Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Manuel","family":"Pineiro\u2010Maceira","sequence":"additional","affiliation":[{"name":"Dermatology Department State University of Rio de Janeiro (UERJ) Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Baptista","family":"Barcaui","sequence":"additional","affiliation":[{"name":"Dermatology Department State University of Rio de Janeiro (UERJ) Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2009.03410.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20132083"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(91)70113-G"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20153437"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14151"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.10.001"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13180"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0365-05962011000400003"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-662-43939-5","volume-title":"Cryosurgery. 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