Actinic keratosis

Approximately 3 months after photodynamic therapy (PDT), the treated skin areas should be re-examined to assess the success of the treatment. Any remaining lesions can then be treated again with PDT.¹

Actinic Keratosis (AK) constitutes a chronic disease. Where AKs are multiple or confluent or at sites of poor healing, patients may warrant long-term follow-up for the associated increased risk of NMSC.²

Regular screening at 6 month intervals is also recommended for patients taking immunosuppressive medications who have a high incidence of AK and skin cancer.³

Basal cell carcinoma

Patients treated with PDT should be reassessed after 3 months and any lesions which have not completely resolved should be re-treated.¹

Patients who have once developed a basal cell carcinoma (BCC) have a significantly higher risk of developing a further BCC.⁴ In addition, such patients are also at risk with regard to the development of further skin tumors, such as squamous cell carcinoma.⁴ Regular follow-up is therefore important for the early detection of local recurrences and second tumors.

The design of the follow-up depends on the risk of recurrence and the number of basal cell carcinomas treated⁵:

• Do not routinely offer follow-up to patients with adequately treated isolated BCC.
• Offer, if possible, at least yearly follow-up to adults with a history of multiple BCCs who are likely to develop further tumours or recurrence within 12 months.

This may need to be more frequent in selected high-risk patients such as those with Gorlin-Goltz syndrome or immunosuppressed organ transplant recipients.

 

Patients with a high risk of developing skin cancer such as those with Gorlin-Goltz syndrome are advised to protect themselves from UV light through a combination of avoiding sunlight exposure, wearing appropriate clothing and the use of sunscreen.⁵

Generally speaking: In addition to regular follow-up as part of skin cancer screening, physicians should instruct their patients to perform regular self-inspection of their skin.
Conspicuous skin changes should then be clarified by a doctor as soon as possible.