Contemporary management of actinic keratosis

Actinic keratosis (AK) is a skin lesion characterized by itraepithelial keratinocyte dysplasia and molecular alterations shared with normal chronically sun-damaged skin and squamous cell carcinoma (SCC). AK can undergo spontaneous regression, stable existence, or malignant transformation to cutaneous SCC with progression rates to SCC ranging from 0% to 0.5% per lesion-year and AK spontaneous regression of 15-63%. As AK is a potential precursor of invasive SCC, it is commonly treated to mitigate the risk of malignant progression, including metastasis and death. There is a myriad of available spots (e.g. cryotherapy) and field (e.g. 5-fluorouracil, imiquimod photodynamic therapy) treatments for AK. Recently published randomized clinical trials have helped bridge the gap on AK management. In this viewpoint, we sought to summarize the most up-to-date evidence in the management of AK.