Objectives: To provide an overview of topical therapies to prevent keratinocyte carcinoma and premalignancies.
Introduction: Keratinocyte carcinoma and premalignant actinic keratoses have significantly increasing incidence rates in fair skinned populations world wide. The risk of actinic keratoses (AK) and squamous cell carcinoma (SCC) is especially increased in patients with photo damaged skin and field cancerization. An overview of topical and systemic treatments to prevent keratinocyte carcinoma will be provided.
Materials / method: A literature search on topical treatments for AK treatment including photodynamic therapy (PDT), imiquimod, 5-fluoruracil, ingenol mebutate and diclofenac was performed
Systemic therapies or supplements were also reviewed.
Results: Photodynamic therapy is a well-documented treatment for secondary prevention in skin with multiple AK as well as repeated PDT has potential on primary prevention of AK in high risk patients. Imiquimod, 5-fluoruracil and ingenol mebutate were also reported to prevent new AK lesions.
In systemic treatments, acitretin reduces the number of keratotic lesions in transplant recipients although effects are only sustained as long as therapy is continued. More recently, oral supplement with niacin reduced BCC and SCC during treatment.
Conclusion: Topical treatments, especially PDT, can prevent AKs and possibly keratinocyte carcinomas. Systemic acitretin and niacin report lower BCC and SCC incidence during on-going therapy.
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