Laura Witte, PhD, PA-C
Purpose: The purpose of this article is to review common field therapies available for treatment of actinic keratoses (AKs) and examine potential long-term benefits of those therapies as compared to liquid nitrogen (LN2). The field therapies reviewed in this article include 5% fluorouracil cream (5-FU), photodynamic therapy (PDT), 5% imiquimod cream, 0.015% ingenol mebutate gel, 3% diclofenac sodium, and 0.5% fluorouracil cream.
Method: A PubMed literature search was conducted with search terms “long-term efficacy of topical therapy for actinic keratosis” and “actinic keratosis field therapy.” Eleven pertinent articles were retrieved and served as the basis for this clinical review.
Results: Numerous field therapies are available to reduce the number of AKs that are typically treated with LN2, and many of these therapies create additional benefits such as prevention of future lesions and a reduction in the development of cutaneous squamous cell carcinoma.
Conclusion: Out of these field therapies reviewed, 5-FU appears to provide the most treatment benefits in clearance of lesions, prevention of future lesions for longer periods, and possible reduction in the risk of developing SCC. Although patients can continue to develop AKs that require further treatment, a significant decrease in the number of AKs reduces the cost and pain associated with LN2 therapy. For most patients with numerous AKs, topical therapies lead to a decreased use of liquid nitrogen, decreased pain, better management, and improved patient satisfaction overall.
Hull AW. A Review of Field Therapies for Treatment of Actinic Keratosis. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(3).
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