Actinic keratosis (AK) lesions are surrounded by field cancerization (areas of subclinical, non-visible sun da-mage). 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 / Dréno, Brigitte; Cerio, Rino; Dirschka, Thomas; Figueras Nart, Ignasi; Lear, John T.; Peris, Ketty; Ruiz de Casas, Andrés; Kaleci, Shaniko; Pellacani, Giovanni. - In: ACTA DERMATO-VENEREOLOGICA. - ISSN 0001-5555. - 97:9(2017), pp. 1108-1113.

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