[Cryosurgical treatment of actinic keratoses and evidence-based review].
BACKGROUND
Actinic keratoses are focal epithelial carcinomas in situ, which are considered precursors of squamous cell carcinoma and must therefore be treated. In the USA, cryosurgery is the most frequent surgical procedure for the treatment of actinic keratoses and considered the treatment of choice.


METHODS
Our own results of cryosurgical treatment of actinic keratoses were evaluated. Original publications and reviews on the treatment of actinic keratoses with cryosurgery were retrieved from MEDLINE and classified according to their evidence level.


RESULTS
Two months after the procedure, 97.0% of the lesions (n=99) were considered sufficiently treated. Local pain during and shortly after treatment (15%) and pigmentary changes (5%) were the most frequent side effects. Recurrences were detected in 2.1% of the lesions during the 1st year and in 11,5% after 3 years. In 2 further monotherapy studies recurrences occurred in 1,2-9% of the lesions after one year in 30% after 3 years. Literature data suggest that photodynamic therapy is equally or even more effective than cryosurgery after a 3-month follow-up. The cryosurgical results were strongly dependent on the attending physician.


CONCLUSIONS
Cryosurgery is beneficial in the treatment of actinic keratoses. This method is equivalent to photodynamic therapy.
Zouboulis
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CC
Klinik und Hochschulambulanz für Dermatologie, Campus Benjamin Franklin der Charité-Universitätsmedizin, Berlin. christos.zouboulis@charite.de
Röhrs
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H
D000368:Aged; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003452:Cryosurgery / Q000379:methods* / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007642:Keratosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D010787:Photosensitivity Disorders / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome