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Actinic (Solar) Keratosis

AK should routinely be managed in primary care. 

 

When to consider referral:

 

For consideration of Photodynamic Therapy (PDT)

 

  • Multiple AK in high risk patients e.g. Previous SCC/organ transplant/immunosuppression
  • Failure of or intolerant to topical therapy in patients with multiple AK/actinic field change/high risk patients

 

Topical treatments to trial in primary care:

 

  • Efudix
  • Picato
  • Actikerall – useful for low or moderately thick hyperkeratotic AK

 

A punch biopsy is not usually necessary but can be useful if there is a poor response to treatment/diagnostic uncertainty.