Field cancerization, a therapeutic challenge

Early treatment of actinic keratoses is preferable especially given the knowledge that an actinic keratoses could be considered as a precursor of a squamous cell carcinoma. Many patients have multiple lesions. This so called field cancerization requires extensive therapy. Unfortunately it is not always easy to determine the best therapy for the patient. Photo dynamic therapy has proven to be an effective treatment to treat larger areas with field cancerization. The main side effect however is that it is often painful, especially for larger treatment areas. Using low fluence rate light fractioned PDT is an option to decrease the pain.