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Giornale Italiano di Dermatologia e Venereologia 2014 April;149(2):199-204


lingua: Inglese

Relapsed actinic keratosis evaluation: an observational Italian multicenter prospective study. Does gender have a role?

Javor S. 1, Chimenti S. 2, Patrizi A. 3, Stingeni L. 4, Pellacani G. 5, Cavicchini S. 6, Sala R. 7, Rongioletti F. 1, Parodi A. 1

1 DiSSal Section of Dermatology, University of Genoa, IRCCS Azienda Ospedaliera Universitaria, San Martino - IST, Genoa, Italy; 2 Department of Dermatology, “Tor Vergata” University of Rome, Rome, Italy; 3 Department of Internal Medicine, Geriatric Diseases and Nephrology, Dermatology Clinic, University of Bologna, Bologna, Italy; 4 Section of Clinical, Allergological and Venereological Dermatology, Department of Medical and Surgical Specialities and Public Healthm, University of Perugia, Perugia, Italy; 5 Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy; 6 Operative Unit of Dermatology, IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano Foundation, Università degli Studi di Milano, Department of Anesthesia and Intensive Therapy and Dermatologic Sciences, Milan, Italy; 7 Department of Dermatology, University of Brescia, Brescia, Italy


AIM: Relapsed actinic keratoses evaluation study (RAKE) was performed in nine Italian centers of dermatology in order to observe the outcome of the treatments of these common skin neoplasms.
METHODS: A total of 182 patients were enrolled in 2 cohorts: the first included 144/182 patients (79.1%) evaluated after 6 months from clinical remission, and the second 116/182 (63.7%) evaluated for at least 12 months after clinical remission. Patients were previously treated with topical diclofenac 3% in hyaluronic acid, cryotherapy, photodynamic, curettage or imiquimod cream.
RESULTS: Subjects with history of malignant skin diseases showed an increased number of new lesions at 16 months from baseline (12 months from remission) compared to patients without history of cancers (mean 1.58 versus 1.17). Hyperkeratotic lesions healed more rapidly but relapsed at 6 months more frequently than non-hyperkeratotic ones (32.9% versus 20.7%). The results showed gender-related differences: male patients recovered better and independently from the treatment used; in contrast, men showed a higher recurrence (32% at 6 months and 6.6% between 6 and 12 months versus 16% at 6 months and 5.9% between 6 and 12 months for females) and a higher average number of new lesions after 12 months from remission (1.6 versus 0.88 for females).
CONCLUSION: The results may suggest a lower adherence to photoprotection in male patients. Hyperkeratotic lesions recurred mostly at 6 months in comparison to non-hyperkeratotic lesions.

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