• Ralf Gutzmer, Susanne Wiegand, Oliver Kölbl, Kai Wermker, Markus Heppt, and Carola Berking.
• Skin Cancer Center Hannover, Department of Dermatology, Hannover Medical School; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig; Department of Radiotherapy, University Hospital Regensburg; Department of Oromaxillofacial, Plastic and Esthetic Surgery, Osnabrück Hospital GmbH, Osnabrück; Department of Dermatology and Allergology, University Hospital (LMU), Munich.
• Dtsch Arztebl Int. 2019 Sep 13; 116 (37): 616626616-626.

BackgroundCutaneous squamous cell carcinoma (cSCC) and its precursors, actinic keratoses (AK), are common. Physicians of multiple specialties are confronted with their treatment.MethodsThis review is based on publications retrieved by a selective search in PubMed, as well as on the German guidelines on AK and cSCC, skin cancer prevention, and surgery with histologic guidance.ResultsLocal treatments for AK include lesional cryotherapy, curettage, and laser ablation as well as field-directed treatments with topical agents, e.g., diclofenac plus hyaluronic acid, imiquimod, 5-fluorouracil, ingenol mebutate, and photodynamic therapy. These treatments can be administered in various sequences or combinations, depending on individual factors and the stage of the disease. The gold standard of treatment for cSCC is histologically confirmed complete resection; radiotherapy is an alternative. Locally uncontrollable or metastatic disease is treated with systemic drugs. The use of various chemotherapeutic agents, EGFR-directed therapies, and the PD-I inhibitor cemiplimab, either singly or in combination, has been described in uncontrolled trials and case series. Cemiplimab has a reported response rate of 47% and was recently approved for the treatment of advanced cSCC.ConclusionThere are many options for the treatment of AK and cSCC that must be considered in the interdisciplinary care of these entities.

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