While there are many treatment options available for actinic keratosis (AK), managing local skin reactions can be a challenge. Next Steps in Derm, in partnership with the ODAC Dermatology Conference, interviewed San Diego dermatologist Neal Bhatia, MD, FAAD, on anticipating and addressing local skin reactions from AK treatment. Watch and learn Dr. Bhatia’s plan for reducing redness and why he’s a no-go on steroids. Learn what types of products and ingredients he recommends that can calm the skin and, in the case of destructive modalities, aid in the wound healing process. With PDT, hear Dr. Bhatia’s topical and oral treatment plan for reducing the impact of exposure to UVA and UVB light in the days immediately following treatment.
Further Reading
If you want to read more about post-treatment care in actinic keratosis, check out the following articles published in the Journal of Drugs in Dermatology:
ABSTRACT
Background: Actinic keratoses (AK) are pre-cancerous, intraepidermal lesions that exist on a continuum with squamous cell carcinoma. Cryotherapy using liquid nitrogen freezing is the most common method for treating AKs. Following cryotherapy, wound care often involves antimicrobial ointments as prophylactics against infection. However, given the rise in antibacterial resistance and possible contact dermatitis, equivalent alternatives should be identified. Cutaneous wound healing is important in dermatologic conditions.
Objective: Evaluate the safety (adverse events) and efficacy (erythema and oozing/crusting, speed of recovery) of post-procedural wound healing of AK lesions, when using either a topical antibiotic (PSO), or a nonprescription repairing balm containing panthenol, madecassoside, and metal salts (CB5).
Methods: A multicenter, intra-individual, randomized control trial was conducted. Sixty participants with at least 3 AK lesions on each arm were enrolled. Following cryotherapy, 3 lesions were selected on each arm for study and control treatment. The treatment of the right or left arm was randomly assigned to either the control group (PSO) or the investigational group (CB5), so that each subject participated in both the investigational and control arms. At each visit, the physician assessed the skin condition (erythema, oozing/crusting) and adverse events, and subject satisfaction was recorded.
Results: There were no clinically significant differences in time to lesion healing, erythema, or oozing/crusting between groups. On day 21, 100% of patients agreed that their lesions had improved. No adverse events related to the study products were reported throughout the trial.
Conclusion: Post-procedural treatment with CB5 and PSO demonstrated equivalent wound healing in participants undergoing liquid nitrogen cryotherapy for AKs without the potential for further adverse effects.
The Utility of Oral Polypodium Leucotomos Extract for Dermatologic Diseases: A Systematic Review
ABSTRACT
Background: Polypodium leucotomos extract (PLE), a fern plant product with strong anti-inflammatory and immunomodulatory properties, has been employed to reduce photoaging and skin cancer. PLE may also serve as an adjuvant treatment for psoriasis, vitiligo, atopic dermatitis, photodermatoses, and melasma. This systematic review synthesizes the current data on PLE usage to manage dermatological diseases.
Methods: This systematic review followed the Agency for Healthcare Research and Quality (AHRQ) Methods Guide for Effectiveness and Comparative Effectiveness Reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) guidelines. PubMed/MEDLINE, Embase, and Cochrane Library were queried using keywords. Articles were screened for inclusion and subsequently grouped by dermatological condition.
Results: Twenty-one of the 152 identified articles met inclusion criteria, including 11 randomized controlled trials and 5 treatment trials. Implicated dermatological conditions were photoaging/skin cancer (9 studies), actinic keratosis (3), photodermatoses (3), melasma (2), vitiligo (3), and atopic dermatitis (1). A thorough article review revealed several potential applications of PLE.
Conclusion: PLE exhibits strong therapeutic potential with an encouraging safety profile. It has photoprotective and immunomodulatory properties, underscoring its potential as an adjuvant therapy for multiple dermatological conditions.
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