title: Management of actinic keratosis: a practical report and treatment algorithm from AKTeam™ expert clinicians.
abstract: BACKGROUND
  Actinic keratoses (AK) are common photo-induced cutaneous lesions that may progress to invasive squamous-cell carcinoma and serve as a risk marker for skin cancer. Although numerous studies present the various therapeutic options for AK, publications that can be used to pragmatically guide dermatologists in their daily practice are limited. National and international guidelines have been published, however, they are based on clinical trials with highly selected patient populations and do not always capture the range of patients seen in everyday practice.
  
  
  OBJECTIVE
  The objective of this expert panel of French dermatologists was to present an analysis of AK geared towards everyday practice, to express an informed opinion about most recent treatments, and to propose a treatment algorithm for AK for daily practice in France.
  
  
  METHODS
  Over a 12 month period, six expert dermatologists in the field of AK (AKTeam(TM) expert panel) met regularly to formulate an opinion about treatment in everyday practice compared with the analysis of the literature and guidelines published since 1990.
  
  
  RESULTS
  Definitions, terminology, diagnosis and risk factors were summarized. Data from the literature and current practices related to the initial evaluation, indications for biopsy, therapeutic indications, therapeutic options and effectiveness, monitoring and prevention were discussed. A pragmatic treatment algorithm was formalized according to current data available. This practical algorithm distinguishes between different clinical situations depending on the number of AK, their hyperkeratotic or suspicious nature, and includes cryotherapy, curettage-electrocoagulation, 5% 5-fluorouracil, 3% diclofenac sodium, 5% imiquimod, 150 and 500 μg/g ingenol mebutate, lasers, photodynamic therapy and surgery.
  
  
  CONCLUSIONS
  This up-to-date expert opinions about AK and its treatment provide a management strategy and practical treatment algorithm for AK for French dermatologists to use.
authors.affiliation: Department of Dermato cancerology, University Hospital Hotel Dieu, Nantes, France.
authors.forename: B
authors.initials: B
authors.lastname: Dréno
authors.forename: J M
authors.initials: JM
authors.lastname: Amici
authors.forename: N
authors.initials: N
authors.lastname: Basset-Seguin
authors.forename: B
authors.initials: B
authors.lastname: Cribier
authors.forename: J P
authors.initials: JP
authors.lastname: Claudel
authors.forename: M A
authors.initials: MA
authors.lastname: Richard
mesh_terms: D000465:Algorithms; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000628:therapy*; D009626:Terminology as Topic