Five year follow up findings testing effectiveness of single ablative fractionated laser resurfacing for the treatment and prevention of actinic neoplasia
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Abstract Body: Actinic keratosis (AK) and non-melanoma skin cancer (NMSC) are common human actinic neoplasia associated with chronic exposure to ultraviolet light and aging. Recent studies indicate that a major factor in the enhanced susceptibility of geriatric skin to photocarcinogenesis is due to the lack of the critical fibroblast-derived mediator insulin-like growth factor-1 (IGF-1), and that wounding therapies upregulate IGF-1 levels. This study aims to define the long-term effectiveness of a single wounding of forearm skin with fractionated laser resurfacing (FLR) on precancerous AKs and NMSCs in aged skin. Data was accumulated for up to 66 months from 48 non-diabetic subjects, aged 60 and older. Previously, data from this cohort at 36 months was published. Participants in this randomized clinical trial with at least five AKs on each dorsal forearm/wrist received a single treatment with a 2,790-nm yttrium scandium gallium garnet fractional ablative resurfacing device to one dorsal forearm/wrist. Follow-up appointments occurred every six months, where AKs/NMSCs were counted on both extremities in blinded fashion. FLR treatment reduced AKs present at the time of treatment and decreased AK development for at least 48 months. At 66 months, 34 NMSCs on untreated arms and 7 NMSCs on FLR treated arms were identified, compared to 24 NMSCs on untreated arms and 2 NMSCs on FLR treated arms at 36 months of follow-up. The numbers of NMSC (predominantly SCC) mirrored the numbers of AKs. Data from this cohort recruited suggests a single wounding of geriatric skin with FLR effectively decreases the incidence of AK/NMSC with lasting protection. Patients with a history of multiple NMSC in particular may benefit from this intervention. Jeffrey B. Travers<sup>1, 2</sup>, Craig A. Rohan<sup>1, 2</sup>, Matthew J. Turner<sup>3, 4</sup>, Dan Spandau<sup>3, 4</sup> 1. Pharmacology & Toxicology, Wright State University Boonshoft School of Medicine, Dayton, OH, United States. 2. Dayton VA Medical Center, Dayton, OH, United States. 3. Dermatology, Indiana University School of Medicine, Indianapolis, IN, United States. 4. Richard L Roudebush VA Medical Center, Indianapolis, IN, United States. Clinical Research: Interventional Research