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Review article: Biomedical intelligence

Vol. 144 No. 5152 (2014)

Swiss clinical practice guidelines on field cancerization of the skin

  • Günther FL Hofbauer
  • Mark Anliker
  • Wolf-Henning Boehncke
  • Christoph Brand
  • Ralph Braun
  • Olivier Gaide
  • Jürg Hafner
  • Robert Hunger
  • Peter Itin
  • Gina Kaeuper
  • Stephan Lautenschlager
  • Carlo Mainetti
  • Markus Streit
Cite this as:
Swiss Med Wkly. 2014;144:w14026


Actinic keratosis (AK) affects millions of people worldwide, and its prevalence continues to increase. AK lesions are caused by chronic ultraviolet radiation exposure, and the presence of two or more AK lesions along with photodamage should raise the consideration of a diagnosis of field cancerization. Effective treatment of individual lesions as well as field cancerization is essential for good long-term outcomes.

The Swiss Registry of Actinic Keratosis Treatment (REAKT) Working Group has developed clinical practice guidelines for the treatment of field cancerization in patients who present with AK. These guidelines are intended to serve as a resource for physicians as to the most appropriate treatment and management of AK and field cancerization based on current evidence and the combined practical experience of the authors. Treatment of AK and field cancerization should be driven by consideration of relevant patient, disease, and treatment factors, and appropriate treatment decisions will differ from patient to patient. Prevention measures and screening recommendations are discussed, and special considerations related to management of immunocompromised patients are provided.


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