光化性角化病:基本原理和管理。

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多兹,贾,Shumack年代

光化性角化病:基本原理和管理。

北京医学(Heidelb)。2014年6月;4 (1):11-31。doi: 10.1007 / s13555 - 014 - 0049 - y。Epub 2014年3月14日。

PubMed ID

24627245 (在PubMed

]

文摘

光化性角质物质(部)是常见的皮肤损伤预示着风险增加发展中鳞状细胞癌(SCC)和其他皮肤恶性肿瘤,产生主要是由于过度暴露于紫外线(UV)。他们主要是在浅肤色的人发现,越来越多的免疫抑制的问题。部可能回归自然,保持稳定或变换浸润性鳞状细胞癌。鳞状细胞癌的风险增加对于那些超过5部,和大多数癌来自部。AK党形成的主要机制是炎症,氧化应激,免疫抑制,受损细胞凋亡,诱变、细胞生长和增殖失调,组织重构。人类乳头状瘤病毒也被卷入一些部的形成。理解这些机制指导部当前可用的治疗方法背后的基本原理。支撑部的管理的主要原则之一是癌化的领域。宽领域的皮肤接触到越来越多的紫外线和其他环境的侮辱我们的年龄。特别是头部,颈部和前臂。 These insults do not target only the skin where individual lesions develop, but also large areas where crops of AKs may appear. The skin between lesions is exposed to the same insults and is likely to contain as-yet undetectable preclinical lesions or areas of dysplastic cells. The whole affected area is known as the 'field'. Management is therefore divided into lesion-directed and field-directed therapies. Current therapies include lesion-directed cryotherapy and/or excision, and topical field-directed creams: 5-fluorouracil, imiquimod, diclofenac, photodynamic therapy and ingenol mebutate. Combining lesion- and field-directed therapies has yielded good results and several novel therapies are under investigation. Treatment is variable and tailored to the individual making a gold standard management algorithm difficult to design. This literature review article aims to describe the rationale behind the best available therapies for AKs in light of current understanding of pathophysiology and epidemiology. A PubMed and MEDLINE search of literature was performed between January 1, 2000 and September 18, 2013. Where appropriate, articles published prior to this have been referenced. This is not a systematic review or meta-analysis, but aims to highlight the most up to date understanding of AK disease and its management.

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