Making proper judgement when choosing a treatment for actinic keratosis

Actinic keratosis is a complex clinical disease for which no clear method exists to predict whether a given lesion will regress, remain stable or progress to non-melanoma skin cancer. Treating all (including subclinical) lesions with field-directed therapy to lower the risk of malignant transformation has been an important evolution in actinic keratosis management. In selected patients, lesion-directed approaches continue to occupy an important role. Despite the associated issues, cryotherapy remains standard of care. Early evidence with a new topical lesion-directed treatment containing low-dose-5-fluorouracil 0.5%/salicylic acid 10% suggests relevant advantages over cryotherapy in terms of sustained lesion clearance. For a condition with such a high global prevalence, remarkably little is known about the economic burden of actinic keratosis and relative cost–effectiveness of the various treatment modalities. Several questions need to be addressed if the challenges of increasing numbers of cases in years...