Dermatology case discussion: Long-term prevention of actinic keratosis

In this week's general dermatology case discussion from Dr John O'Bryen, we look at a 67-year-old male patient who requires a field treatment for diffuse actinic keratoses on his face. He is now on day 12 after commencing compounded 5% fluorouracil and 0.005% calcipotriol cream, applied twice daily for four days. 

What can he now apply to his skin for relief? What can he apply on his skin long-term to prevent actinic keratosis relapse?

Update

To relieve the skin, which is now cracked and peeling, Dr John O'Bryen recommended regular and liberal application of either CeraVe Advanced Repair Balm or La Roche-Posay Cicaplast Baume B5+ Balm.

If patients get particularly inflamed, sore, and swollen, Dr O'Bryen prescribes methylprednisolone aceponate 0.1% fatty ointment to use for several days until their skin is relieved.

Long term, he will recommend morning application of La Roche-Posay Anthelios KA+ Sunscreen SPF 50+, which contains niacinamide and panthenol, to sun damaged skin to prevent relapse of actinic keratoses. 

Below is a photo of the gentleman on day 25.

General Dermatology case discussion presented and moderated by Dr John O'Bryen and brought to you by La Roche Posay.

Contributing to the General Dermatology Case Discussion Blog helps meet your annual Performance Review CPD requirement!

Comment/engage with colleagues’ cases  = 0.5 CPD hours (Performance Review)

How to claim your CPD hours If you interact with this case, you can Quick Log your CPD hours with the RACGP via the usual self-submission process. You will be asked to reflect on what you have learned, and you will require proof you interacted with the blog; a screenshot will suffice.