The Experts below are selected from a list of 1374 Experts worldwide ranked by ideXlab platform

Giovanni Pellacani - One of the best experts on this subject based on the ideXlab platform.

  • defining the actinic keratosis Field a literature review and discussion
    Journal of The European Academy of Dermatology and Venereology, 2018
    Co-Authors: Figueras Nart, Thomas Dirschka, John T. Lear, Rino Cerio, Ketty Peris, Brigitte Dréno, Giovanni Pellacani, Ruiz A De Casas
    Abstract:

    Despite the chronic and increasingly prevalent nature of actinic keratosis (AK) and existing evidence supporting assessment of the entire Cancerization Field during clinical management, a standardized definition of the AK Field to aid in the understanding and characterization of the disease is lacking. The objective of this review was to present and appraise the available evidence describing the AK Cancerization Field, with the aim of determining a precise definition of the AK Field in terms of its molecular (including genetic and immunological), histological and clinical characteristics. Eight European dermatologists collaborated to conduct a review and expert appraisal of articles detailing the characteristics of the AK Field. Articles published in English before August 2016 were identified using PubMed and independently selected for further assessment according to predefined preliminary inclusion and exclusion criteria. In addition, a retrospective audit of patients with AK was performed to define the AK Field in clinical terms. A total of 32 review articles and 47 original research articles provided evidence of sun-induced molecular (including genetic and immunological) and histological skin changes in the sun-exposed area affected by AK. However, the available literature was deemed insufficient to inform a clinical definition of the AK Field. During the retrospective audit, visible signs of sun damage in 40 patients with AK were assessed. Telangiectasia, atrophy and pigmentation disorders emerged as 'reliable or very reliable' indicators of AK Field based on expert opinion, whereas 'sand paper' was deemed a 'moderately reliable' indicator. This literature review has revealed a significant gap of evidence to inform a clinical definition of the AK Field. Therefore, the authors instead propose a clinical definition of Field Cancerization based on the identification of visible signs of sun damage that are reliable indicators of Field Cancerization based on expert opinion.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity.
    Acta Dermato-venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity
    Society for Publication of Acta Dermato-Venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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 practic

Brigitte Dréno - One of the best experts on this subject based on the ideXlab platform.

  • defining the actinic keratosis Field a literature review and discussion
    Journal of The European Academy of Dermatology and Venereology, 2018
    Co-Authors: Figueras Nart, Thomas Dirschka, John T. Lear, Rino Cerio, Ketty Peris, Brigitte Dréno, Giovanni Pellacani, Ruiz A De Casas
    Abstract:

    Despite the chronic and increasingly prevalent nature of actinic keratosis (AK) and existing evidence supporting assessment of the entire Cancerization Field during clinical management, a standardized definition of the AK Field to aid in the understanding and characterization of the disease is lacking. The objective of this review was to present and appraise the available evidence describing the AK Cancerization Field, with the aim of determining a precise definition of the AK Field in terms of its molecular (including genetic and immunological), histological and clinical characteristics. Eight European dermatologists collaborated to conduct a review and expert appraisal of articles detailing the characteristics of the AK Field. Articles published in English before August 2016 were identified using PubMed and independently selected for further assessment according to predefined preliminary inclusion and exclusion criteria. In addition, a retrospective audit of patients with AK was performed to define the AK Field in clinical terms. A total of 32 review articles and 47 original research articles provided evidence of sun-induced molecular (including genetic and immunological) and histological skin changes in the sun-exposed area affected by AK. However, the available literature was deemed insufficient to inform a clinical definition of the AK Field. During the retrospective audit, visible signs of sun damage in 40 patients with AK were assessed. Telangiectasia, atrophy and pigmentation disorders emerged as 'reliable or very reliable' indicators of AK Field based on expert opinion, whereas 'sand paper' was deemed a 'moderately reliable' indicator. This literature review has revealed a significant gap of evidence to inform a clinical definition of the AK Field. Therefore, the authors instead propose a clinical definition of Field Cancerization based on the identification of visible signs of sun damage that are reliable indicators of Field Cancerization based on expert opinion.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity.
    Acta Dermato-venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity
    Society for Publication of Acta Dermato-Venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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 practic

Marco Bisoffi - One of the best experts on this subject based on the ideXlab platform.

  • towards a personalized surgical margin for breast conserving surgery implications of Field Cancerization in local recurrence
    Journal of Surgical Oncology, 2017
    Co-Authors: Katarina Lebya, Marco Bisoffi, Nancy E Joste, Anna C Jones, Randi Garciasmith, Radha Swaminathan, John C Russell, Kristina A Trujillo
    Abstract:

    The amount of normal tissue that should be excised during breast conserving surgery is widely debated. Tissue adjacent to breast tumors, although histologically normal, possesses many of the molecular abnormalities found in tumor tissues. Here, we propose that the ideal physical distance for a surgical margin may not be universal. Rather, an adequate surgical margin likely varies from patient to patient, depending on the biology of the tissue that remains after surgery. J. Surg. Oncol. © 2017 Wiley Periodicals, Inc.

  • prostate Field Cancerization deregulated expression of macrophage inhibitory cytokine 1 mic 1 and platelet derived growth factor a pdgf a in tumor adjacent tissue
    PLOS ONE, 2015
    Co-Authors: Anna C Jones, Marco Bisoffi, Kristina A Trujillo, Edgar G Fischer, Kresta S Antillon, Shannon M Jenkins, Sara N Janos, Heidi N Overton, Dor Shoshan
    Abstract:

    Prostate Field Cancerization denotes molecular alterations in histologically normal tissues adjacent to tumors. Such alterations include deregulated protein expression, as we have previously shown for the key transcription factor early growth response 1 (EGR-1) and the lipogenic enzyme fatty acid synthase (FAS). Here we add the two secreted factors macrophage inhibitory cytokine 1 (MIC-1) and platelet derived growth factor A (PDGF-A) to the growing list of protein markers of prostate Field Cancerization. Expression of MIC-1 and PDGF-A was measured quantitatively by immunofluorescence and comprehensively analyzed using two methods of signal capture and several groupings of data generated in human cancerous (n = 25), histologically normal adjacent (n = 22), and disease-free (n = 6) prostate tissues. A total of 208 digitized images were analyzed. MIC-1 and PDGF-A expression in tumor tissues were elevated 7.1x to 23.4x and 1.7x to 3.7x compared to disease-free tissues, respectively (p<0.0001 to p = 0.08 and p<0.01 to p = 0.23, respectively). In support of Field Cancerization, MIC-1 and PDGF-A expression in adjacent tissues were elevated 7.4x to 38.4x and 1.4x to 2.7x, respectively (p<0.0001 to p<0.05 and p<0.05 to p = 0.51, respectively). Also, MIC-1 and PDGF-A expression were similar in tumor and adjacent tissues (0.3x to 1.0x; p<0.001 to p = 0.98 for MIC-1; 0.9x to 2.6x; p<0.01 to p = 1.00 for PDGF-A). All analyses indicated a high level of inter- and intra-tissue heterogeneity across all types of tissues (mean coefficient of variation of 86.0%). Our data shows that MIC-1 and PDGF-A expression is elevated in both prostate tumors and structurally intact adjacent tissues when compared to disease-free specimens, defining Field Cancerization. These secreted factors could promote tumorigenesis in histologically normal tissues and lead to tumor multifocality. Among several clinical applications, they could also be exploited as indicators of disease in false negative biopsies, identify areas of repeat biopsy, and add molecular information to surgical margins.

  • markers of fibrosis and epithelial to mesenchymal transition demonstrate Field Cancerization in histologically normal tissue adjacent to breast tumors
    International Journal of Cancer, 2011
    Co-Authors: Kristina A Trujillo, Christopher M Heaphy, Marco Bisoffi, Nancy E Joste, Anna C Jones, Kimberly S Butler, Minh Mai, Keith M Vargas, Jeffrey Griffith
    Abstract:

    Previous studies have shown that a Field of genetically altered but histologically normal tissue extends 1 cm or more from the margins of human breast tumors. The extent, composition and biological significance of this Field are only partially understood, but the molecular alterations in affected cells could provide mechanisms for limitless replicative capacity, genomic instability and a microenvironment that supports tumor initiation and progression. We demonstrate by microarray, qRT-PCR and immunohistochemistry a signature of differential gene expression that discriminates between patient-matched, tumor-adjacent histologically normal breast tissues located 1 cm and 5 cm from the margins of breast adenocarcinomas (TAHN-1 and TAHN-5, respectively). The signature includes genes involved in extracellular matrix remodeling, wound healing, fibrosis and epithelial to mesenchymal transition (EMT). Myofibroblasts, which are mediators of wound healing and fibrosis, and intra-lobular fibroblasts expressing MMP2, SPARC, TGF-β3, which are inducers of EMT, were both prevalent in TAHN-1 tissues, sparse in TAHN-5 tissues, and absent in normal tissues from reduction mammoplasty. Accordingly, EMT markers S100A4 and vimentin were elevated in both luminal and myoepithelial cells, and EMT markers α-smooth muscle actin and SNAIL were elevated in luminal epithelial cells of TAHN-1 tissues. These results identify cellular processes that are differentially activated between TAHN-1 and TAHN-5 breast tissues, implicate myofibroblasts as likely mediators of these processes, provide evidence that EMT is occurring in histologically normal tissues within the affected Field and identify candidate biomarkers to investigate whether or how Field Cancerization contributes to the development of primary or recurrent breast tumors.

  • differential gene expression in tumor adjacent histologically normal prostatic tissue indicates Field Cancerization
    International Journal of Oncology, 2009
    Co-Authors: Christina M Haaland, Christopher M Heaphy, Jeffrey Griffith, Kimberly S Butler, Edgar G Fischer, Marco Bisoffi
    Abstract:

    Field Cancerization denotes the occurrence of aberrant cells in tumor adjacent histologically normal tissues (TAHN). To characterize Field Cancerization in prostate cancer, we used RNA from paired patient tumor and TAHN tissues excised at 1 cm from the tumor margin and subjected them to microarray expression analysis comparative to RNA from normal cancer-free prostatic tissues. Eleven novel transcripts were significantly up-regulated in TAHN tissues and also in tumors. Expression of early growth response protein 1, tristetraprolin, testican, and fatty acid synthase, mutually up-regulated at different levels in tumors and TAHN tissues was confirmed by quantitative reverse transcriptase PCR in the experimental and in an independent validation set. This study offers proof of expressional changes in Field cancerized prostatic TAHN tissues at defined distances from tumor margins. Markers of Field cancerized prostatic tissues could be early diagnostic indicators in biopsies after abnormal prostate-specific antigen and digital rectal examination and independent of cancerous histology and/or early targets for chemo-preventive intervention in pre-malignant disease.

  • telomere dna content and allelic imbalance demonstrate Field Cancerization in histologically normal tissue adjacent to breast tumors
    International Journal of Cancer, 2006
    Co-Authors: Christopher M Heaphy, Marco Bisoffi, Colleen A Fordyce, Christina M Haaland, William C Hines, Nancy E Joste, Jeffrey Griffith
    Abstract:

    Cancer arises from an accumulation of mutations that promote the selection of cells with progressively malignant phenotypes. Previous studies have shown that genomic instability, a hallmark of cancer cells, is a driving force in this process. In the present study, two markers of genomic instability, telomere DNA content and allelic imbalance, were examined in two independent cohorts of mammary carcinomas. Altered telomeres and unbalanced allelic loci were present in both tumors and surrounding histologically normal tissues at distances at least 1 cm from the visible tumor margins. Although the extent of these genetic changes decreases as a function of the distance from the visible tumor margin, unbalanced loci are conserved between the surrounding tissues and the tumors, implying cellular clonal evolution. Our results are in agreement with the concepts of "Field Cancerization" and "cancer Field effect," concepts that were previously introduced to describe areas within tissues consisting of histologically normal, yet genetically aberrant, cells that represent fertile grounds for tumorigenesis. The finding that genomic instability occurs in Fields of histologically normal tissues surrounding the tumor is of clinical importance, as it has implications for the definition of appropriate tumor margins and the assessment of recurrence risk factors in the context of breast-sparing surgery.

Rino Cerio - One of the best experts on this subject based on the ideXlab platform.

  • defining the actinic keratosis Field a literature review and discussion
    Journal of The European Academy of Dermatology and Venereology, 2018
    Co-Authors: Figueras Nart, Thomas Dirschka, John T. Lear, Rino Cerio, Ketty Peris, Brigitte Dréno, Giovanni Pellacani, Ruiz A De Casas
    Abstract:

    Despite the chronic and increasingly prevalent nature of actinic keratosis (AK) and existing evidence supporting assessment of the entire Cancerization Field during clinical management, a standardized definition of the AK Field to aid in the understanding and characterization of the disease is lacking. The objective of this review was to present and appraise the available evidence describing the AK Cancerization Field, with the aim of determining a precise definition of the AK Field in terms of its molecular (including genetic and immunological), histological and clinical characteristics. Eight European dermatologists collaborated to conduct a review and expert appraisal of articles detailing the characteristics of the AK Field. Articles published in English before August 2016 were identified using PubMed and independently selected for further assessment according to predefined preliminary inclusion and exclusion criteria. In addition, a retrospective audit of patients with AK was performed to define the AK Field in clinical terms. A total of 32 review articles and 47 original research articles provided evidence of sun-induced molecular (including genetic and immunological) and histological skin changes in the sun-exposed area affected by AK. However, the available literature was deemed insufficient to inform a clinical definition of the AK Field. During the retrospective audit, visible signs of sun damage in 40 patients with AK were assessed. Telangiectasia, atrophy and pigmentation disorders emerged as 'reliable or very reliable' indicators of AK Field based on expert opinion, whereas 'sand paper' was deemed a 'moderately reliable' indicator. This literature review has revealed a significant gap of evidence to inform a clinical definition of the AK Field. Therefore, the authors instead propose a clinical definition of Field Cancerization based on the identification of visible signs of sun damage that are reliable indicators of Field Cancerization based on expert opinion.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity.
    Acta Dermato-venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity
    Society for Publication of Acta Dermato-Venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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 practic

Thomas Dirschka - One of the best experts on this subject based on the ideXlab platform.

  • defining the actinic keratosis Field a literature review and discussion
    Journal of The European Academy of Dermatology and Venereology, 2018
    Co-Authors: Figueras Nart, Thomas Dirschka, John T. Lear, Rino Cerio, Ketty Peris, Brigitte Dréno, Giovanni Pellacani, Ruiz A De Casas
    Abstract:

    Despite the chronic and increasingly prevalent nature of actinic keratosis (AK) and existing evidence supporting assessment of the entire Cancerization Field during clinical management, a standardized definition of the AK Field to aid in the understanding and characterization of the disease is lacking. The objective of this review was to present and appraise the available evidence describing the AK Cancerization Field, with the aim of determining a precise definition of the AK Field in terms of its molecular (including genetic and immunological), histological and clinical characteristics. Eight European dermatologists collaborated to conduct a review and expert appraisal of articles detailing the characteristics of the AK Field. Articles published in English before August 2016 were identified using PubMed and independently selected for further assessment according to predefined preliminary inclusion and exclusion criteria. In addition, a retrospective audit of patients with AK was performed to define the AK Field in clinical terms. A total of 32 review articles and 47 original research articles provided evidence of sun-induced molecular (including genetic and immunological) and histological skin changes in the sun-exposed area affected by AK. However, the available literature was deemed insufficient to inform a clinical definition of the AK Field. During the retrospective audit, visible signs of sun damage in 40 patients with AK were assessed. Telangiectasia, atrophy and pigmentation disorders emerged as 'reliable or very reliable' indicators of AK Field based on expert opinion, whereas 'sand paper' was deemed a 'moderately reliable' indicator. This literature review has revealed a significant gap of evidence to inform a clinical definition of the AK Field. Therefore, the authors instead propose a clinical definition of Field Cancerization based on the identification of visible signs of sun damage that are reliable indicators of Field Cancerization based on expert opinion.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity.
    Acta Dermato-venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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.

  • A Novel Actinic Keratosis Field Assessment Scale for Grading Actinic Keratosis Disease Severity
    Society for Publication of Acta Dermato-Venereologica, 2017
    Co-Authors: Brigitte Dréno, Thomas Dirschka, Ignasi Figueras Nart, John T. Lear, Andrés Ruiz De Casas, Rino Cerio, Ketty Peris, Shaniko Kaleci, Giovanni Pellacani
    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 practic