{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:59:30Z","timestamp":1778695170635,"version":"3.51.4"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T00:00:00Z","timestamp":1589241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Patient-centered motives and expectations of the treatment of actinic keratoses (AK) have received little attention until now. Hence, we aimed to profile and cluster treatment motivations and expectations among patients with AK in a nationwide multicenter, cross-sectional study including patients from 14 German skin cancer centers. Patients were asked to complete a self-administered questionnaire. Treatment motives and expectations towards AK management were measured on a visual analogue scale from 1\u201310. Specific patient profiles were investigated with subgroup and correlation analysis. Overall, 403 patients were included. The highest motivation values were obtained for the items \u201cavoid transition to invasive squamous cell carcinoma\u201d (mean \u00b1 standard deviation; 8.98 \u00b1 1.46), \u201cAK are considered precancerous lesions\u201d (8.72 \u00b1 1.34) and \u201ctreating physician recommends treatment\u201d (8.10 \u00b1 2.37; p &lt; 0.0001). The highest expectation values were observed for the items \u201ceffective lesion clearance\u201d (8.36 \u00b1 1.99), \u201csafety\u201d (8.20 \u00b1 2.03) and \u201ctreatment-related costs are covered by health insurance\u201d (8.00 \u00b1 2.41; p &lt; 0.0001). Patients aged \u226577 years and those with \u22657 lesions were identified at high risk of not undergoing any treatment due to intrinsic and extrinsic motivation deficits. Heat mapping of correlation analysis revealed four clusters with distinct motivation and expectation profiles. This study provides a patient-based heuristic tool for a personalized treatment decision in patients with AK.<\/jats:p>","DOI":"10.3390\/jcm9051438","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T10:53:55Z","timestamp":1589280835000},"page":"1438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Treatment Motivations and Expectations in Patients with Actinic Keratosis: A German-Wide Multicenter, Cross-Sectional Trial"],"prefix":"10.3390","volume":"9","author":[{"given":"Theresa","family":"Steeb","sequence":"first","affiliation":[{"name":"Department of Dermatology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1940-5115","authenticated-orcid":false,"given":"Anja","family":"Wessely","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"von Bubnoff","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Schleswig-Holstein Campus L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Dirschka","sequence":"additional","affiliation":[{"name":"Centroderm Clinic, 42287 Wuppertal, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantin","family":"Drexler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Regensburg, 93042 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conrad","family":"Falkenberg","sequence":"additional","affiliation":[{"name":"Centroderm Clinic, 42287 Wuppertal, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7575-6230","authenticated-orcid":false,"given":"Jessica C.","family":"Hassel","sequence":"additional","affiliation":[{"name":"Section of Dermatooncology, Department of Dermatology and National Center for Tumor Diseases, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinan","family":"Hayani","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svea","family":"H\u00fcning","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital of Dortmund, 44137 Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina C.","family":"K\u00e4hler","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Schleswig-Holstein Campus Kiel, 24105 Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0144-3420","authenticated-orcid":false,"given":"Sigrid","family":"Karrer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Regensburg, 93042 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7276-7812","authenticated-orcid":false,"given":"Christian","family":"Krammer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8019-1577","authenticated-orcid":false,"given":"Ulrike","family":"Leiter","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Center for Dermatooncology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Lill","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8716-2568","authenticated-orcid":false,"given":"Enklajd","family":"Marsela","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Meiwes","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Center for Dermatooncology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doroth\u00e9e","family":"Nashan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital of Dortmund, 44137 Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzan","family":"Nasifoglu","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital, LMU Munich, 80337 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutz","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Skin Cancer Center, Ruhr University Bochum, 44801 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Sirokay","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital of Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Thiem","sequence":"additional","affiliation":[{"name":"Clinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5316-0241","authenticated-orcid":false,"given":"Jochen","family":"Utikal","sequence":"additional","affiliation":[{"name":"Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9313-6588","authenticated-orcid":false,"given":"Alexander","family":"Zink","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, Technical University of Munich, 80802 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola","family":"Berking","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus V.","family":"Heppt","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Universit\u00e4tsklinikum Erlangen, Friedrich-Alexander-University of Erlangen-N\u00fcrnberg (FAU), 91054 Erlangen, Germany"},{"name":"Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054 Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1067\/mjd.2000.103342","article-title":"Epidemiology of actinic keratoses and squamous cell carcinoma","volume":"42","author":"Salasche","year":"2000","journal-title":"J. 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