Treatments of actinic cheilitis: A systematic review of the literature - 19/08/20
Abstract |
Background |
No large studies have defined the best treatment of actinic cheilitis.
Methods |
We conducted a systematic review to define the best therapies for actinic cheilitis in clinical response and recurrences.
Results |
We first identified 444 papers, and 49 were finally considered, including 789 patients and 843 treated areas. The following therapies were recorded in order of frequency: laser therapy, photodynamic therapy (PDT), 3% diclofenac in 2.5% hyaluronic acid, PDT + 5% imiquimod, aminolevulinic acid–laser or methyl-aminolevulinic acid–laser, 5% imiquimod, fluorouracil, partial surgery, 0.015% ingenol mebutate, 50% trichloroacetic acid, and laser + PDT. Concerning the primary outcome, complete clinical response was achieved in 76.5% of patients, and 10.2% had clinical recurrences. Partial surgery and laser therapy showed the highest complete response rates (14 of 14 [100%] and 244 of 260 [93.8%], respectively) with low recurrences. Only a limited number of patients were treated with other therapies, with the exception of PDT, with 68.9% complete responses and 12.6% of recurrences. Interestingly, when combined with 5% imiquimod, the efficacy of PDT was significantly enhanced.
Limitations |
Heterogeneity across studies.
Conclusion |
Laser therapy appears the best option among nonsurgical approaches for actinic cheilitis, and PDT showed higher efficacy when sequentially combined with 5% imiquimod. Larger studies are needed to confirm these data.
Le texte complet de cet article est disponible en PDF.Key words : actinic cheilitis, diclofenac, imiquimod, laser, photodynamic therapy, treatment
Abbreviations used : AC, AE, ALA, DHA, Er:YAG, FU, IMI, IngMeb, MAL, PDT, SCC, TCA
Plan
Drs Lai and Pampena contributed equally to this work. |
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Funding sources: None. |
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Conflicts of interest: None. |
Vol 83 - N° 3
P. 876-887 - septembre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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