Treatment of keratoses and lentigines with peels and PDT

Abstract

The dorsum of the hands can portray an aged appearance due to sun damage. Contributing to the aged appearance are epidermal and dermal atrophy, prominent veins, solar lentigines, and actinic keratoses. Treatment of nonfacial solar lentigines and actinic keratosis is critical in providing a true age defying body rejuvenation. With actinic keratoses considered a precancerous disease state, treatment is not only cosmetically appealing but also medically pertinent. Treatment is often unrewarding using conventional approaches for facial lesions such as cryotherapy, topical fluorouracil, topical hydroquinone, and lasers due to discomfort, scarring, dyspigmentation, lack of efficacy, healing time, and cost.1 Given how some treatments require a considerable amount of patience and patient compliance, practicality also becomes an issue. The lack of abundant sebaceous material, which confers suboptimal healing, in the hands does not allow for aggressive treatment. Ultimately, patients would like to achieve success with removing age defining lesions, such as solar lentigines and actinic keratoses with the same success and ease which clinicians have been performing on the face. Fortunately, two relatively old treatments for this situation, photodynamic therapy (PDT) and chemical peels, have been revisited with surprising success, offering good clearance and relative ease of application and most importantly excellent patient satisfaction. © 2010 Springer Science+Business Media, LLC.