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Pharmacologic agents are a key therapeutic strategy, and ongoing research continues to refine which drugs provide the greatest benefit for specific patient groups. Clinicians must consider medical history, lesion location, and tolerability when selecting therapy. This review surveys drugs used for prevention and treatment, comparing agents such as nicotinamide, acitretin, and topical 5-fluorouracil, along with other accepted approaches for lesion eradication.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pharmacological-agents-used-in-the-prevention-and-treatment-of-actinic-keratosis-a-review/376579/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pharmacological-agents-used-in-the-prevention-and-treatment-of-actinic-keratosis-a-review/376579.png","ImageObject",300,407,{"name":92,"@type":93},"Jiven","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is actinic keratosis considered high risk if left untreated?","Question",{"text":112,"@type":113},"Actinic keratosis can progress toward cutaneous squamous cell carcinoma (SCC) and, if untreated, may transform into SCC.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which pharmacologic agents are highlighted for prevention or treatment of actinic keratosis?",{"text":117,"@type":113},"The review emphasizes nicotinamide, acitretin, topical 5-fluorouracil (including combination formulations), and also discusses imiquimod, diclofenac, and photodynamic light therapy.",{"name":119,"@type":110,"acceptedAnswer":120},"How do clinicians decide which treatment agent to use for different patients?",{"text":121,"@type":113},"Selection depends on factors such as past personal medical history, lesion location, and tolerability, and the review notes uncertainty about which agents best suit immunocompetent versus immunodeficient/immunosuppressed patients.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},376579,1790520678,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","Review  \nPharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review  \nDomenico Arcuri 1, Brandon Ramchatesingh 1, François Lagac² 1, Lisa Iannattone 1, Elena Netchiporouk 1, Philippe Lefrançois 1 and Ivan V. Litvinov 1,2, *  \nCitation: Arcuri, D.; Ramchatesingh,  \nB.; Lagacé, F.; Iannattone, L.;  \nNetchiporouk, E.; Lefrançois, P.; Litvinov, I.V. Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: AReview. Int. J. Mol. Sci. 2023, 24, 4989 .  \n[https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)ijms24054989  \nAcademic Editors: Apostolos E. Papalois and Georgios Antonios Margonis  \nReceived: 31 December 2022  \nRevised: 17 February 2023  \nAccepted: 21 February 2023  \nPublished: 5 March 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Medicine, McGill University, Montreal, QC H4A 3J1, Canada  \n2 Division of Dermatology, McGill University Health Center, Montreal, QC H4A 3J1, Canada  \n* Correspondence: [ivan.litvinov@mcgill.ca](ivan.litvinov@mcgill.ca)  \nAbstract: Actinic keratosis (AK) is among the most commonly diagnosed skin diseases with potentially life-threatening repercussions if left untreated. Usage of pharmacologic agents represents oneof many therapeutic strategies that can be used to help manage these lesions. Ongoing research into these compounds continues to change our clinical understanding as to which agents most benefit particular patient populations. Indeed, factors such as past personal medical history, lesion location and tolerability of therapy only represent a few considerations that clinicians must account for when prescribing appropriate treatment. This review focuses on specific drugs used in either the prevention or treatment of AKs. Nicotinamide, acitretin and topical 5-fluorouracil (5-FU) continue to be used with fidelity in the chemoprevention of actinic keratosis, although some uncertainty persists in regard to which agents should be used in immunocompetent vs. immunodeficient/immunosuppressed patients. Topical 5-FU, including combination formulations with either calcipotriol or salicylic acid, as well as imiquimod, diclofenac and photodynamic light therapy are all accepted treatment strategies employed to target and eliminate AKs. Five percent of 5-FU is regarded as the most effective therapy in the condition, although the literature has conflictingly shown that lower concentrations of the drug might also be as effective. Topical diclofenac (3%) appears to be less efficacious than 5% 5-FU, 3.75–5% imiquimod and photodynamic light therapy despite its favorable side effect profile. Finally, traditional photodynamic light therapy, while painful, appears to be of higher efficacy in comparison to its more tolerable counterpart, daylight phototherapy.  \nKeywords: actinic keratosis; squamous cell carcinoma; SCC; NMSC; pharmacotherapy; 5-FU; acitretin; nicotinamide; calcipotriol; salicylic acid; imiquimod; diclofenac; photodynamic light therapy; PDT; daylight; dPDT; ALA; MAL  \n1. Introduction  \nActinic keratosis (AK), synonymously referred to as solar keratosis, is among the most commonly diagnosed skin pathologies by dermatologists in the United States and Canada [1] . AK lesions are frequently found on sun-exposed areas of the body, such as the face, neck, dorsum of the hands, forearms and lower legs [2] . The risk of developing AK appears to be associated with cumulative ultraviolet (UV) exposure, as older individuals with lighter phototypes (Fitzpatrick I or II) tend to be the most vulnerable to developing the disease [3,4] . Indeed, studies analyzing AK prevalence among various age groups have reve","cbCaipecDvOPlX5M","https://ap.wps.com/l/cbCaipecDvOPlX5M","pdf",822562,26,"English","# Introduction\n## Pharmacologic prevention and treatment strategies for AK\n## Progression risk: AK and cutaneous squamous cell carcinoma (SCC)\n## Clinically relevant factors in selecting therapy","[{\"question\":\"Why is actinic keratosis considered high risk if left untreated?\",\"answer\":\"Actinic keratosis can progress toward cutaneous squamous cell carcinoma (SCC) and, if untreated, may transform into SCC.\"},{\"question\":\"Which pharmacologic agents are highlighted for prevention or treatment of actinic keratosis?\",\"answer\":\"The review emphasizes nicotinamide, acitretin, topical 5-fluorouracil (including combination formulations), and also discusses imiquimod, diclofenac, and photodynamic light therapy.\"},{\"question\":\"How do clinicians decide which treatment agent to use for different patients?\",\"answer\":\"Selection depends on factors such as past personal medical history, lesion location, and tolerability, and the review notes uncertainty about which agents best suit immunocompetent versus immunodeficient/immunosuppressed patients.\"}]","Pharmacological Agents Used in the Prevention and Treatment of Actinic Keratosis: A Review | PDF",1790220076,66]