Journal of Clinical & Experimental Dermatology Research
Open Access

Abstract

Prevention Strategies in Patients affected by Actinic Keratosis of the Head: A 12-Month, Prospective, Assessor-Blinded, Controlled Study with Lesion-Directed Treatment Associated with Medicalized Photoprotection

Arianna Lamberti, Alessandra Cartocci, Carolina Donelli, Giulio Cortonesi, Emanuele Trovato, Massimo Milani*, Pietro Rubegni and Elisa Cinotti

Objective: We assessed the efficacy of a 100+SPF sunscreen containing DNA-repairing enzymes (endonuclease, glycosylase, and photolyase) and a potent antioxidant extract (Polypodium Leucotomos Extract: PLE) (“Medicalized” Photoprotection: MP), in subjects with Actinic Keratosis (AK) treated with cryotherapy measuring the evolution of AKASI score and through a non-invasive analysis with Line-field Confocal-Optical Coherence Tomography (LC)- OCT.

Patients and Methods: A prospective, 12-month, assessor-blinded, controlled study enrolling patients with ≤ 5 actinic keratoses on the face and/or scalp suitable for cryotherapy was performed. After cryotherapy, 30 subjects were instructed to apply the MP twice daily for 12 consecutive months. Thirty subjects were selected as a control group. AKASI score was evaluated at baseline, after 3 and 12 months.

Results: MP was associated with a significant reduction (p<0.05) of AKASI score after 3 and 12 months. The score of the treatment group doesn't differ from the control group one at baseline, but it was significantly lower after 12 months. LC-OCT evaluation showed, at the end of treatment period in comparison with baseline that the thickness of the epithelium and the stratum corneum significantly decreased. A significant decrease of disarranged epithelial architecture, dyskeratotic keratinocytes, atypical nuclei and dilated vessels has been also observed. A significant increase (p=0.045) of the Outlined Dermo-Epidermal Junction (ODEJ), was observed.

Conclusion: PLE-based MP significantly improves AKASI score in subjects after cryotherapy treatment in comparison with controls. In addition, our study showed that morphological features identified by LC-OCT could be potentially useful for the follow-up of AK subjects.

Published Date: 2022-11-15; Received Date: 2022-10-14