2024+欧洲共识指南:日光性角化病、上皮紫外线诱发的异常增生和区域癌化的诊断、治疗和预防.pdf
《2024+欧洲共识指南:日光性角化病、上皮紫外线诱发的异常增生和区域癌化的诊断、治疗和预防.pdf》由会员分享,可在线阅读,更多相关《2024+欧洲共识指南:日光性角化病、上皮紫外线诱发的异常增生和区域癌化的诊断、治疗和预防.pdf(24页珍藏版)》请在咨信网上搜索。
1、J Eur Acad Dermatol Venereol.2024;00:124.| U I DE L I N E SEuropean consensus-based interdisciplinary guideline for diagnosis,treatment and prevention of actinic keratoses,epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology,European Dermatolo
2、gy Forum,European Academy of Dermatology and Venereology and Union of Medical Specialists(Union Europenne des Mdecins Spcialistes)LidijaKandolf1|KettyPeris2,3|JosepMalvehy4|KlaraMosterd5,6|Markus V.Heppt7,8|Maria ConcettaFargnoli9|CarolaBerking7,8|PetrArenberger10|MatildaBylaite-Buinskiene11|Veroniq
3、uedel Marmol12|ThomasDirschka13,14|BrigitteDreno15|Ana-MariaForsea16|Catherine A.Harwood17|AxelHauschild18|Ida MarieHeerfordt19|RolandKauffman20|NicoleKellenersSmeeths5,6|AimiliosLallas21|CelesteLebbe22|UlrikeLeiter23|CaterinaLongo24|eljkoMijukovi1|GiovanniPellacani25|SusanaPuig4|PhilippeSaiag26|Mir
4、naitum27|EggertStockfleth28|CarmenSalavastru29|AlexanderStratigos30|IrisZalaudek31|ClausGarbe23|on behalf of European Association of Dermato-Oncology,European Dermatology Forum,European Academy of Dermatology and Venereology and Union of Medical Specialists(Union Europenne des Mdecins Spcialistes)Re
5、ceived:29 August 2023|Accepted:23 January 2024DOI:10.1111/jdv.19897 2024 European Academy of Dermatology and Venereology.For Affiliation refer page on 18CorrespondenceLidija Kandolf,Department of Dermatology,Faculty of Medicine,University of Defence,Military Medical Academy,Belgrade,Serbia.Email:Abs
6、tractA collaboration of multidisciplinary experts from the European Association of Dermato-Oncology,the European Dermatology Forum,the European Academy of Dermatology and Venereology,and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and trea
7、tment,based on current literature and expert consensus.This guideline addresses the epi-demiology,diagnostics,risk stratification and treatments in immunocompetent as well as immunosuppressed patients.Actinic keratoses(AK)are potential precursors of cutaneous squamous cell carcinoma(cSCC)and display
8、 typical histopathologic and immunohistochemical features of this malignancy in an early stage.They can develop into cSSC insitu and become invasive in a low percentage of cases.AK is the most frequent neoplasia in white populations,frequently occurring within a cancer-ous field induced by ultraviol
9、et radiation.Since it cannot be predicted,which lesion will progress to cSCC and when treatment is usually recommended.The diagnosis of 2|EUROPEAN GUIDELINE FOR TREATMENT OF AKINTRODUCTIONSocieties in chargeThis guideline was developed on behalf of the European Dermatology Forum(EDF).The European As
10、sociation of Dermato-Oncology(EADO)coordinated the authors con-tributions as part of its Guideline Program in Oncology(GPO).The editors and coordinators responsible for the formulation of the guideline were Lidija Kandolf,Claus Garbe,Josep Malvehy,Klara Mosterd,Maria Concetta Fargnoli,Markus Heppt a
11、nd Carola Berking.To ensure the interdisciplinary quality of the guidelines,they were developed in cooperation with the European Dermatology Forum(EDF)and the European Union of Medical Specialists(Union Europenne des Mdecins Spcialistes,UEMS).DisclaimerAll statements related to the definition,classi
12、fication,diag-nosis and treatment of actinic keratosis(AK)correspond to the current scientific knowledge,based on the data from the literature available at the time of printing the guidelines.The attending physician invoking these guideline recom-mendations must consider scientific progress since th
13、e pub-lication of the guideline.The user remains responsible for all diagnostic and therapeutic applications,medications and doses.Just as adherence to the guidelines may not con-stitute defence against a claim of negligence(malpractice),deviation from them should not necessarily be deemed negligent
14、.These guidelines will require updating approxi-mately every 2 years but advances in medical sciences may demand an earlier update.Registered trademarks(pro-tected product names)are not specified in these guidelines.This work is protected by copyrights in all its parts.Any utilization outside the pr
15、ovision of the copyright act with-out the written permission by the GPO of the EADO is pro-hibited and punishable by law.No part of this work may be reproduced in any way without written permission by the GPO.This applies to duplications,translations,microfilm-ing and the storage,application and uti
16、lization in electronic systems,intranets and Internet.ScopeThis guideline was developed to assist clinicians in diagnos-ing and treating patients with epithelial dysplasia,including AK.In recent years,significant rise of incidence of keratino-cyte cancers is evident,leading to the increased burden o
17、n the society.Also,advances were made in understanding of keratinocyte dysplasia,and the concept of field cancerization was introduced and adopted by the dermatology commu-nity.Different classification schemes of epithelial dysplasia and AK were developed to guide the treatment approach in everyday
18、practice.New insights in the efficacy and safety of different topical treatments and destructive methods for this condition were also developed.It is recognized by the sci-entific community that these conditions should be treated and monitored to prevent the transformation to invasive cutaneous squa
19、mous cell carcinoma.Thus,the use of these guidelines that incorporate the updated scientific knowledge in the field of definition,diagnosis and treatment of epithe-lial dysplasia,AK and field cancerization in clinical routine should improve patient care.Target populationThe guidelines have been prep
20、ared for the clinicians who take care of the patients with AK and keratinocyte carcino-mas in general.These are mainly dermatologists.Objectives and formulation of questionsThe guidelines have been developed and organized in clear sections,based on the latest data from the literature,to sup-port cli
21、nicians in finding the answers to questions relevant to the everyday practice on:(a)definition of AK and field cancerization and their relation to cutaneous squamous cell carcinoma(cSSC);(b)epidemiology and pathophysiology;(c)which examinations methods are reliable for diagnosis and do we need histo
22、pathologic confirmation?(d)is there a rationale for early treatment of AK and which patient should receive which treatment?(e)how we should follow-up pa-tients with AK and(f)what preventive measure can be ad-vised to the patients?AK and field cancerization is made by clinical examination.Dermatoscop
23、y,confocal microscopy,optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms.A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions.The choice of treatment depends on patients
24、and lesion characteristics.For single non-hyperkeratotic lesions,the treatment can be started upon patients request with destructive treatments or topical treatments.For multiple lesions,field cancerization treatment is advised with topical treatments and photodynamic therapy.Preventive measures suc
25、h as sun protection,self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.|3KANDOLF etal.Principles of methodologyThe literature search was carried out by the authors using PubMed,and only articles published until September 2
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