Real-World Data on Characteristics and Management of Patients with Actinic Keratosis: A Cancer Center Experience †

Background/Objectives: Actinic keratosis is an intraepithelial lesion that may progress into squamous cell carcinoma; therefore, all lesions should be treated. The study aimed to investigate the potential correlations between patient and lesion characteristics, treatment option choice, and clinical outcomes, analyzing long-term real-world data. Methods: A retrospective study was conducted in a specialized hospital in Milan. Data on patients with actinic keratoses were collected from January 2018 to July 2024. Results: A total of 369 patients were included, with normal weight (58%), higher educational level (83%), personal skin cancer history (51%), childhood sunburns (68%), and face localization (70%), with multiple contiguous distribution (54%) of lesions. In total, 45.5% received multiple treatments. Field-directed therapies were prescribed in 84% of cases (32% of complete clearance). A total of 43% were lost to follow-up. Higher educational level, personal and familiar skin cancer history, previous atypical naevus excision, higher naevus count, and multiple treatments (p < 0.05) were associated with regularity in visit attendance. In multivariable analysis, immunosuppression (OR = 5.01 [0.97, 29.5], p = 0.056) and multiple contiguous lesions (OR = 4.62 [1.75, 14.7], p = 0.004) were found to be significantly associated with incomplete clinical response. Conclusions: Real-world data on patients with actinic keratoses may help identify more personalized management strategies that influence treatment outcomes and adherence to follow-up.