The State of the Art in the Treatment of Actinic Keratosis and Field Cancerization: A Narrative Review

Actinic keratosis (AK) is considered the early phase of a squamous cell carcinoma (SCC) and represents one of the most common epithelial skin lesions, with an estimated global prevalence of approximately 14%. An estimated annual risk of progression has been reported with a range from 0 to 0.53%. Although spontaneous regression of individual AK lesions has been described in approximately 23% of cases, the frequent presence of multiple lesions, usually in the broader context of field cancerization, significantly diminishes the likelihood of regression and contributes to a higher cumulative risk of progression to SCC. The aim of the present narrative review was to provide an overview of the current evidence of the most effective available lesion-directed and field-directed treatments for actinic keratoses, on the personalized, combined, or sequential approach, as well as on the emerging therapeutic options.