PHYSICIANS’ POINT OF VIEW ON ACTINIC KERATOSIS 

Giornale Italiano di Dermatologia e Venereologia 2014 April;149(2):185-92

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Physicians’ opinions and clinical practice patterns for actinic keratosis management in Italy

Peris K. ¹, Neri L. ², Calzavara Pinton P. ³, Catricalà C. ⁴, Pellacani G. ⁵, Pimpinelli N. ⁶, Peserico A. ⁷ ✉

¹ Department of General Oncological Dermatology, L’Aquila University, L’Aquila, Italy; ² Department of Clinical Community Sciences, University of Milan, Milan, Italy; ³ Dermatologic Clinic, University of Brescia, Brescia, Italy; ⁴ IFO-Istituto Dermatologico Santa Maria e San Gallicano IRCCS, Rome, Italy; ⁵ Operative Unit of Dermatology, Policlinico di Modena University Hospital, Modena, Italy; ⁶ Unit of Dermatology and Dermatologic Physiotherapy, Azienda Sanitaria di Firenze, Department of Surgery and Transational Medicine, University of Florence, Florence, Italy; ⁷ DIMED Department of Medicine Dermatologic Clinic, University of Padua, Padua, Italy

AIM: We report dermatologists’ opinions and clinical practice patterns about clinical factors driving decision making in the management of actinic keratosis (AK) in Italy.
METHODS: We carried out a cross-sectional survey among 33 Italian dermatologists. Physicians were asked to report their management choices in consecutive patients with AK seen at their practice within 2 weeks since study initiation. We collected patients’ clinical and socio-demographic characteristics with a standardized data collection form and assessed physicians’ opinions on AK management with a self-reported questionnaire.
RESULTS: Six hundred fifty-seven patients with new, single AK lesions without evidence of photo-damaged skin in the surrounding areas, were predominantly treated with lesion-directed therapies (primarily cryotherapy). In contrast, physicians preferentially prescribed field-directed therapies to patients with multiple lesions and evidence of photo-damaged skin in AK surrounding areas. However we observed a wide variation in treatment choices and physicians’ opinions on AK management. Dermatologists underlined the importance of fostering patients’ adherence and minimize therapy side effects.
CONCLUSION: Overall, our results show that current guidelines regarding management of AK are only partially integrated in dermatology practice. The active dissemination of up-to-date national guidelines might help harmonize clinical decision making in this complex and fast growing therapeutic area.