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It contrasts options such as imiquimod, diclofenac, 5-fluorouracil, photodynamic therapy, and nicotinamide, noting reduced performance in solid organ transplant recipients due to immunosuppression. The review emphasizes combination regimens, highlights cryoimmunotherapy, and surveys newer agents including resimiquimod and anti-PD1 while identifying the need for further standardization.",{"@graph":69,"@context":126},[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/topical-immunotherapy-for-actinic-keratosis-and-field-cancerization/327238/",{"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/topical-immunotherapy-for-actinic-keratosis-and-field-cancerization/327238.png","ImageObject",300,407,{"name":92,"@type":93},"Olivia Brown","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main focus of this review?","Question",{"text":112,"@type":113},"The review focuses on topical immunotherapy approaches for actinic keratoses (AKs) and field cancerization, especially therapies whose mechanisms involve immune system participation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which AK treatments are discussed, and how do they relate to immune effects?",{"text":117,"@type":113},"It covers treatments such as imiquimod and diclofenac for immune modulation, as well as therapies like 5-fluorouracil, photodynamic therapy, and nicotinamide that can have immunological contributions beyond acting on dysplastic cells.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is treatment efficacy different in solid organ transplant recipients?",{"text":121,"@type":113},"Efficacy is reduced because solid organ transplant recipients require immunosuppressive regimens, which weaken immune responses relevant to these therapies.",{"name":123,"@type":110,"acceptedAnswer":124},"What combination and newer immunotherapies are highlighted?",{"text":125,"@type":113},"The review emphasizes optimal combination strategies, with cryoimmunotherapy highlighted as most relevant, and it surveys newer immunotherapies such as resimiquimod, ingenol disoxate, PALA, and anti-PD1 while noting more studies are needed to standardize use.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},327238,1790018414,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":148},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","cancers   \nReview  \nTopical Immunotherapy for Actinic Keratosis and Field Cancerization  \nLaura Bernal Masferrer 1,*, Tamara Gracia Cazaña 1, Isabel Bernad Alonso 1, Marcial Álvarez-Salafranca 1,  \nManuel Almenara Blasco 1, María Gallego Rentero 2, Ángeles Juarranz de la Fuente 2 and Yolanda Gilaberte 1  \nCitation: Bernal Masferrer, L.;  \nGracia Cazaña, T.; Bernad Alonso, I.;Álvarez-Salafranca, M.; Almenara Blasco, M.; Gallego Rentero, M.; Juarranz de la Fuente, Á.; Gilaberte, Y. Topical Immunotherapy for Actinic Keratosis and Field Cancerization. Cancers 2024, 16, 1133. [https://](https://)[ ](https://)[doi.org/10.3390/cancers16061133](doi.org/10.3390/cancers16061133)  \nAcademic Editor: Alessandro Pileri  \nReceived: 9 February 2024  \nRevised: 3 March 2024  \nAccepted: 8 March 2024  \nPublished: 12 March 2024  \nCopyright: © 2024 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 Service of Dermatology, Miguel Servet University Hospital, 50009 Zaragoza, Spain;  \n[tgraciac@salud.aragon.es](tgraciac@salud.aragon.es) (T.G.C.); [ibernad@salud.aragon.es](ibernad@salud.aragon.es) (I.B.A.); [malvarezs@salud.aragon.es](malvarezs@salud.aragon.es) (M.Á .-S.);  \n[malmenara@salud.aragon.es](malmenara@salud.aragon.es) (M.A.B.); [ygilaberte@salud.aragon.es](ygilaberte@salud.aragon.es) (Y.G.)  \n2 Department of Biology, Universidad Autónoma de Madrid, 28049 Madrid, Spain;  \n[maria.gallego@uam.es](maria.gallego@uam.es) (M.G.R.); angeles.juarranz@uam.es (Á .J.d.l.F.)  \n* Correspondence: [laurabermas@gmail.com](laurabermas@gmail.com)  \nSimple Summary: The primary focus of this review revolves around actinic keratoses (AKs), common skin conditions primarily induced by prolonged sun exposure. These lesions are of particular concern due to their potential progression into skin cancer, thereby warranting in-depth investigation for effective treatment and prevention strategies. There are different approaches to treat AK; some of them target the dysplastic cells, whereas others act on the immunological response of the host to fight against abnormal cells. This review summarizes all the therapies used for AK and field cancerization, whose mechanism of action include the participation of the immune system. Moreover, the research extends to immunosuppressed individuals, mainly organ transplant recipients, who require tailored approaches due to their immune profiles. In essence, this research tries to update the therapeutic approaches for AKs, ultimately lowering the risk of malignant transformation and contributing to improved clinical management.  \nAbstract: This comprehensive review delves into various immunotherapeutic approaches for the management of actinic keratoses (AKs), precancerous skin lesions associated with UV exposure. Although there are treatments whose main mechanism of action is immune modulation, such as imiquimod or diclofenac, other treatments, apart from their main effect on dysplastic cells, exert some immunological action, which in the end contributes to their efficacy. While treatments like 5-fluorouracil, imiquimod, photodynamic therapy, and nicotinamide are promising in the management of AKs, especially in immunocompetent individuals, their efficacy is somewhat reduced in solid organ transplant recipients due to immunosuppression. The analysis extends to optimal combination, focusing on cryoimmunotherapy as the most relevant. New immunotherapies include resimiquimod, ingenol disoxate, N-phosphonacetyl-L-aspartate (PALA), or anti-PD1 that have shown promising results, although more studies are needed in order to standardize their use.  \nKeywords: actinic keratosis; cancerization field; immunotherapy; immunosuppression; diclofenac disodium; imiqu","cbCaiflROAoefAjx","https://ap.wps.com/l/cbCaiflROAoefAjx","pdf",1997425,"English","# Introduction\n## Immunotherapeutic Approaches for Actinic Keratoses\n## Treatment Efficacy in Immunocompetent vs Immunosuppressed Patients\n## Combination Strategies and Cryoimmunotherapy\n## Emerging Immunotherapies and Evidence Gaps","[{\"question\":\"What is the main focus of this review?\",\"answer\":\"The review focuses on topical immunotherapy approaches for actinic keratoses (AKs) and field cancerization, especially therapies whose mechanisms involve immune system participation.\"},{\"question\":\"Which AK treatments are discussed, and how do they relate to immune effects?\",\"answer\":\"It covers treatments such as imiquimod and diclofenac for immune modulation, as well as therapies like 5-fluorouracil, photodynamic therapy, and nicotinamide that can have immunological contributions beyond acting on dysplastic cells.\"},{\"question\":\"Why is treatment efficacy different in solid organ transplant recipients?\",\"answer\":\"Efficacy is reduced because solid organ transplant recipients require immunosuppressive regimens, which weaken immune responses relevant to these therapies.\"},{\"question\":\"What combination and newer immunotherapies are highlighted?\",\"answer\":\"The review emphasizes optimal combination strategies, with cryoimmunotherapy highlighted as most relevant, and it surveys newer immunotherapies such as resimiquimod, ingenol disoxate, PALA, and anti-PD1 while noting more studies are needed to standardize use.\"}]","Topical Immunotherapy for Actinic Keratosis and Field Cancerization | PDF",1789976782,48]