1. A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity
- Author
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Dreno, Brigitte, Cerio, Rino, Dirschka, Thomas, Figueras Nart, Ignasi, Lear, John T., Peris, Ketty, Ruiz de Casas, Andrés, Kaleci, Shaniko, Pellacani, Giovanni, and Progressing Evidence in AK (PEAK) Working Group
- Subjects
medicine.medical_specialty ,Actinic ,Keratosis ,Hyperkeratosis ,Actinic keratosis ,Field cancerization ,Grading scale ,Face ,Humans ,Keratosis, Actinic ,Reproducibility of Results ,Scalp ,Sunlight ,Photography ,Severity of Illness Index ,2708 ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Disease severity ,lcsh:Dermatology ,Medicine ,Grading (tumors) ,Tumors ,business.industry ,Field assessment ,Sun damage ,General Medicine ,lcsh:RL1-803 ,medicine.disease ,fieldcancerization ,Skin diseases ,Malalties de la pell ,030220 oncology & carcinogenesis ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,business ,actinickeratosis ,gradingscale - Abstract
Actinic keratosis (AK) lesions are surrounded by field cancerization (areas of subclinical, non-visible sun damage). Existing AK grading tools rely on AK counts, which are not reproducible. An Actinic Keratosis Field Assessment Scale (AK-FAS) for grading the severity of AK/field was developed. Standardized photographs of patients representing the full range of AK severity were collected. Six investigators independently rated each photograph according to 3 criteria: AK area (total skin area affected by AK lesions), hyperkeratosis and sun damage. Inter-rater reproducibility was good for all 3 criteria. Validation of the AK-FAS showed good reproducibility for AK area and hyperkeratosis, even for dermatologists untrained on use of the scale. In conclusion, the AK-FAS is objective, easy to use and implement, and reproducible. It incorporates assessment of the entire field affected by AK instead of relying on lesion counts. Use of the AK-FAS may standardize AK diagnosis, making it relevant to routine clinical practice.
- Published
- 2017