Background: No large studies have defined the best treatment of actinic cheilitis. Methods: We conducted a systematic review to define the best therapies for actinic cheilitis in clinical response and recurrences. Results: We first identified 444 papers, and 49 were finally considered, including 789 patients and 843 treated areas. The following therapies were recorded in order of frequency: laser therapy, photodynamic therapy (PDT), 3% diclofenac in 2.5% hyaluronic acid, PDT + 5% imiquimod, aminolevulinic acid–laser or methyl-aminolevulinic acid–laser, 5% imiquimod, fluorouracil, partial surgery, 0.015% ingenol mebutate, 50% trichloroacetic acid, and laser + PDT. Concerning the primary outcome, complete clinical response was achieved in 76.5% of patients, and 10.2% had clinical recurrences. Partial surgery and laser therapy showed the highest complete response rates (14 of 14 [100%] and 244 of 260 [93.8%], respectively) with low recurrences. Only a limited number of patients were treated with other therapies, with the exception of PDT, with 68.9% complete responses and 12.6% of recurrences. Interestingly, when combined with 5% imiquimod, the efficacy of PDT was significantly enhanced. Limitations: Heterogeneity across studies. Conclusion: Laser therapy appears the best option among nonsurgical approaches for actinic cheilitis, and PDT showed higher efficacy when sequentially combined with 5% imiquimod. Larger studies are needed to confirm these data.
Lai, M., Pampena, R., Cornacchia, L., Pellacani, G., Peris, K., Longo, C., Treatments of actinic cheilitis: A systematic review of the literature, <<JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY>>, 2020; 83 (3): 876-887. [doi:10.1016/j.jaad.2019.07.106] [http://hdl.handle.net/10807/168608]
Treatments of actinic cheilitis: A systematic review of the literature
Cornacchia, Luigi;Peris, Ketty;
2020
Abstract
Background: No large studies have defined the best treatment of actinic cheilitis. Methods: We conducted a systematic review to define the best therapies for actinic cheilitis in clinical response and recurrences. Results: We first identified 444 papers, and 49 were finally considered, including 789 patients and 843 treated areas. The following therapies were recorded in order of frequency: laser therapy, photodynamic therapy (PDT), 3% diclofenac in 2.5% hyaluronic acid, PDT + 5% imiquimod, aminolevulinic acid–laser or methyl-aminolevulinic acid–laser, 5% imiquimod, fluorouracil, partial surgery, 0.015% ingenol mebutate, 50% trichloroacetic acid, and laser + PDT. Concerning the primary outcome, complete clinical response was achieved in 76.5% of patients, and 10.2% had clinical recurrences. Partial surgery and laser therapy showed the highest complete response rates (14 of 14 [100%] and 244 of 260 [93.8%], respectively) with low recurrences. Only a limited number of patients were treated with other therapies, with the exception of PDT, with 68.9% complete responses and 12.6% of recurrences. Interestingly, when combined with 5% imiquimod, the efficacy of PDT was significantly enhanced. Limitations: Heterogeneity across studies. Conclusion: Laser therapy appears the best option among nonsurgical approaches for actinic cheilitis, and PDT showed higher efficacy when sequentially combined with 5% imiquimod. Larger studies are needed to confirm these data.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.