Journal Article Review Epublish
PubMed: 42652870 DOI: 10.3390/jcm15166467
The Role of General Practitioners in Actinic Keratosis Management in Europe: A Dermato-Oncologists Initiative.
J Clin Med 15(16)
Authors: Claas Ulrich, Markus V Heppt, Giuseppe Argenziano, Maria Concetta Fargnoli, Carla Ferrándiz-Pulido, Thomas Jouary, Aimilios Lallas, César Martins, Klara Mosterd, Philippe Saiag, Nathalie Bégeault, Alba Crespo-Cruz
Affiliations
- Collegium Medicum GmbH, 10117 Berlin, Germany. Charité-Universitätsmedizin Berlin, Institut für Allergieforschung IFA & Fraunhofer Standort Immunologie und Allergologie IA, 10117 Berlin, Germany.
- Department of Dermatology, Deutsches Zentrum Immuntherapie (DZI), Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
- Comprehensive Cancer Center, Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), 91054 Erlangen, Germany.
- Bavarian Cancer Research Center (BZKF), 91054 Erlangen, Germany.
- Dermpath München, Laboratory for Dermatopathology, Oral Pathology and Molecular Pathology, 80335 Munich, Germany.
- Dermatology Unit, University of Campania, 80138 Naples, Italy.
- San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy.
- Dermatology Department, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain.
- Dermatology Unit, Hospital Francois Mitterrand, 64000 Pau, France.
- First Department of Dermatology and Venereology, School of Medicine, Faculty of Health Sciences, Aristotle University, 54124 Thessaloniki, Greece.
- Department of Dermatology, ULS Médio Tejo, 2350 Torres Novas, Portugal.
- Department of Dermatology, Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands.
- GROW Research Institute for Oncology and Reproduction, Maastricht University, 6200 MD Maastricht, The Netherlands.
- Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, & EA 4340 "Biomarkers in Cancerology and OncoHematology", UVSQ, Université Paris-Saclay, 92100 Boulogne-Billancourt, France.
- Medical Dermatology Department, Pierre Fabre Médicament, Les Cauquillous, 81506 Lavaur, France.
Abstract
Background/Objectives: Actinic keratosis (AK) is the key precursor of invasive cutaneous squamous cell carcinoma (cSCC). Rising incidence, ageing populations, and limited dermatologists' availability, particularly in rural and underserved regions, underscore the need for more inclusive care pathways. As in other common diseases such as diabetes or hypertension, general practitioners (GPs) could play a pivotal role in improving access, early recognition, and management of AK, provided that systemic barriers are addressed. Methods: This article synthesises current evidence and expert insights from a European multi-country advisory process, focusing on Italy, France, Germany, Spain, Portugal, the Netherlands, and Greece. The advisory board comprised dermatologists selected based on their clinical expertise and national representativeness, and consensus was reached through structured discussion and iterative review of background materials. Results/Conclusions: The study outlines unmet needs, barriers, and enablers for GPs' involvement and proposes a structured strategy supported by consensus recommendations. It offers a pragmatic model for improving AK care through stronger collaboration between primary care and dermatology. Greater GPs' involvement may support earlier recognition, better triage, improved access to care, and more efficient use of specialist services, while ensuring that complex or high-risk lesions remain under dermatologists' oversight. This may help optimise AK care pathways across Europe.
MeSH
General Practitioners, Keratosis, Keratosis, Actinic, Oncologists, Dermatologists