title: Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version.
abstract: BACKGROUND
  Actinic keratosis (AK) is a frequent health condition attributable to chronic exposure to ultraviolet radiation. Several treatment options are available and evidence based guidelines are missing.
  
  
  OBJECTIVE
  The goal of these evidence- and consensus-based guidelines was the development of treatment recommendations appropriate for different subgroups of patients presenting with AK. A secondary aim of these guidelines was the implementation of knowledge relating to the clinical background of AK, including consensus-based recommendations for the histopathological definition, diagnosis and the assessment of patients.
  
  
  METHODS
  The guidelines development followed a pre-defined and structured process. For the underlying systematic literature review of interventions for AK, the methodology suggested by the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was adapted. All recommendations were consented during a consensus conference using a formal consensus methodology. Strength of recommendations was expressed based on the GRADE approach. If expert opinion without external evidence was incorporated into the reasoning for making a certain recommendation, the rationale was provided. The Guidelines underwent open public review and approval by the commissioning societies.
  
  
  RESULTS
  Various interventions for the treatment of AK have been assessed for their efficacy. The consenting procedure led to a treatment algorithm as shown in the guidelines document. Based on expert consensus, the present guidelines present recommendations on the classification of patients, diagnosis and histopathological definition of AK. Details on the methods and results of the systematic literature review and guideline development process have been published separately.
  
  
  CONCLUSIONS
  International guidelines are intended to be adapted to national or regional circumstances (regulatory approval, availability and reimbursement of treatments).
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: R N
authors.initials: RN
authors.lastname: Werner
authors.affiliation: Department of Dermatology, Venerology and Allergology, Skin Cancer Center (HTCC), Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Stockfleth
authors.affiliation: Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Connolly
authors.affiliation: Centro Dermatologia Epidermis, Instituto CUF and Faculty of Medicine of University of Porto, Porto, Portugal.
authors.forename: O
authors.initials: O
authors.lastname: Correia
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Erdmann
authors.affiliation: Skin and Cancer Foundation Victoria, Carlton, Victoria, Australia.|St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.|The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Foley
authors.affiliation: Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Mediprobe Research Inc., London, Ontario, Canada.
authors.forename: A K
authors.initials: AK
authors.lastname: Gupta
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Jacobs
authors.affiliation: Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Kerl
authors.affiliation: Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA.
authors.forename: H W
authors.initials: HW
authors.lastname: Lim
authors.affiliation: Dermatology Laser Center of Maui, Kihei, Hawaii, USA.
authors.forename: G
authors.initials: G
authors.lastname: Martin
authors.affiliation: Mediprobe Research Inc., London, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Paquet
authors.affiliation: Division of Dermatology and Virginia Clinical Research Inc, Eastern Virginia Medical School, Norfolk, Virginia, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Pariser
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Rosumeck
authors.affiliation: Division of Dermatopathology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Röwert-Huber
authors.affiliation: Department of Dermatology, Whipps Cross University Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sahota
authors.affiliation: Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.|Department of Dermatology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
authors.forename: O P
authors.initials: OP
authors.lastname: Sangueza
authors.affiliation: Department of Dermatology, Northern Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Shumack
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Sporbeck
authors.affiliation: Dermatology, Surgery, and Otolaryngology, Oregon Health and Science University, Portland, Oregon, USA.|Surgical and Cosmetic Dermatology and Clinical Operations, Oregon Health and Science University Knight Cancer Institute, Portland, Oregon, USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Swanson
authors.affiliation: Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Torezan
authors.affiliation: Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Nast
mesh_terms: D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
keywords: actinic keratosis; evidence based medicine; guideline; international guideline; practice guideline; recommendations; solar keratosis; squamous cell carcinoma; treatment