Updates on Treatment Approaches for Cutaneous Field Cancerization

Abstract

Purpose of Review: Field cancerization describes the phenomenon that multiple heterogenous mutations may arise in an area exposed to chronic carcinogenic stimuli. Advances in the understanding of cutaneous field cancerization have led to novel therapeutic approaches to the management of actinic keratoses (AKs). Herein, we review the literature on the pathophysiology and emerging research of field cancerization in dermatology. Recent Findings: The classification systems for grading AK lesions are being refined with investigations focusing on their clinical utility. There is a growing shift toward field-directed treatment for AKs as the importance of field cancerization becomes clearer. Current field-directed therapies are being optimized and novel therapeutic modalities are being studied. Summary: Field cancerization underlies the transformation of photodamaged skin into AKs and potentially cutaneous squamous cell carcinoma (cSCC). Clinically meaningful classification systems for AKs are needed to better inform decisions regarding treatment. As we learn more about the role of field characterization in photodamage, AKs, and cSCCs, therapeutic strategies are becoming more field-directed rather than lesion-directed.