At skin level, a cancerization field (CF) indicates some chronically photoexposed areas in which, besides a primary tumor, histological or biomolecular modifications without clinical signs are present.,Active telethermography (ATT) allows us to observe the imaging of a hyperthermic halo (HH) surrounding the tumor .,The Authors hypothesize HH as a possible expression of CF.,The aim of this study were to verify whether HHs have the same histological or immunohistochemical characteristics as the CF and, secondly, to evaluate the efficacy of a device containing the enzyme photolyase in modifying thermographic parameters in these area.,The study included 30 patients affected by actinic keratosis, evaluated clinically and by ATT at time 0 and after 3, 6 and 9 months.,The ATT showed the presence of HHs in all the patients and, after the treatment, a significant modification of both the extension of these areas and the thermal parameters.,In 5 patients for whom, while operated, two other biopsies were performed, respectively on the HH and on a perilesional non-hyperthermic area, in the HH, we detected a p53 and Ki 67 over-expression.,Our results indicate that ATT could represent a useful paraclinic method in identifying CFs in subjects at risk.
Actinic keratosis is a common cause of dermatological consultations and it presents a strong association with squamous cell carcinoma.,Many substances are used for treatment and prevention, such as retinoids.,Nevertheless, many studies on retinoids emphasize their application in treating and preventing non melanoma skin cancers.,In this article, we reviewed studies about systemic and topical retinoids used with immunocompetent patients and organ transplant recipients with actinic keratosis, as primary or secondary outcomes.,The majority of these papers pointed to a reduction in actinic keratosis count after treatment with retinoids.,However, studies need to be better-defined in order to address the lack of a standardized dose, the absence of control groups, the low number of patients and short follow-up periods.,Blind, randomized and controlled clinical trials with adequate sample sizes, specifically focused on actinic keratosis, are needed to clarify the real benefit of topical and/or oral retinoids.,Comparison of efficacy and safety between oral and topical retinoids in the prevention and treatment of non-melanoma skin cancers and actinic keratosis is an essential pre requisite to establish new strategies to control these conditions.