Date of Presentation

5-4-2023 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Introduction: Chronic UV radiation affects the entire area of skin exposed, leading to visible actinic keratoses (AK) and subclinical changes in the surrounding skin. AKs are hyperkeratotic lesions, with a 0.025-16% risk of transforming into squamous cell carcinoma (SCC).1 Cellular atypia around AKs is the field of cancerization (FOC). Topical AK therapies can treat the FOC, while destructive treatments address visible lesions. FDA-approved products may be approved for field sizes up to 25 cm2.1,2

Objective: To characterize the FOC and assess the correlation between the FOC and number of AKs.

Methods: 100 patients with AKs were recruited. FOC was defined by a dermatologist. The size of the FOC was quantified to determine if FOC meets FDA-recommended AK topical treatment criteria.

Results: 100 patients (mean age 71.2 years; 23% female) with AKs were enrolled, with 148 FOC. The mean AKs per field was 6.8 (SD=7.3). Mean size of the FOC was 75.3cm2 (SD=75). 111 of the 148 fields (75%) exceeded 25cm2. Number of AKs positively correlated with the size of the FOC. Mean FOC size and the mean number of AKs differed based on the body region affected (p=0.0337; p=0.0087).

Conclusion: Cellular atypia changes due to UV radiation are important because if the surrounding area of atypia is not treated along with the visible AK, patients remain at risk for AK recurrence and progression to SCCs. Results suggest treating FOC of 25 cm2 may not be adequate for patients. AK therapy should consider FOC size, number of AKs, and patient preferences.

Keywords

Ultraviolet Rays, Actinic Keratosis, Neoplasms, Squamous Cell Carcinoma, Therapeutics

Disciplines

Dermatology | Diagnosis | Medicine and Health Sciences | Neoplasms | Oncology | Pathological Conditions, Signs and Symptoms | Skin and Connective Tissue Diseases | Surgical Procedures, Operative

Document Type

Poster

COinS
 
May 4th, 12:00 AM

The Clinical Definition and Characterization of Field of Cancerization in Patients with Actinic Keratoses

Introduction: Chronic UV radiation affects the entire area of skin exposed, leading to visible actinic keratoses (AK) and subclinical changes in the surrounding skin. AKs are hyperkeratotic lesions, with a 0.025-16% risk of transforming into squamous cell carcinoma (SCC).1 Cellular atypia around AKs is the field of cancerization (FOC). Topical AK therapies can treat the FOC, while destructive treatments address visible lesions. FDA-approved products may be approved for field sizes up to 25 cm2.1,2

Objective: To characterize the FOC and assess the correlation between the FOC and number of AKs.

Methods: 100 patients with AKs were recruited. FOC was defined by a dermatologist. The size of the FOC was quantified to determine if FOC meets FDA-recommended AK topical treatment criteria.

Results: 100 patients (mean age 71.2 years; 23% female) with AKs were enrolled, with 148 FOC. The mean AKs per field was 6.8 (SD=7.3). Mean size of the FOC was 75.3cm2 (SD=75). 111 of the 148 fields (75%) exceeded 25cm2. Number of AKs positively correlated with the size of the FOC. Mean FOC size and the mean number of AKs differed based on the body region affected (p=0.0337; p=0.0087).

Conclusion: Cellular atypia changes due to UV radiation are important because if the surrounding area of atypia is not treated along with the visible AK, patients remain at risk for AK recurrence and progression to SCCs. Results suggest treating FOC of 25 cm2 may not be adequate for patients. AK therapy should consider FOC size, number of AKs, and patient preferences.

 

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