Key points

• The likely benefits of the various therapies proposed for AK and BD are summarised in Table 28.1.

• We found good evidence to suggest that oral retinoids and topical 5-FU may be beneficial in the treatment of AK.

• The evidence supporting the efficacy of most therapies is insufficient or limited.

• Studies were not consistent in choosing their unit of analyses. Some used number of lesions, other used persons cleared, and others used both as their unit of analyses. Readers should determine which unit is most relevant to their practice.

• The evidence for treatment of BD is generally of poor quality.

• Choice of therapy in BD should consider location of lesions, particularly the lower legs and the digits, where healing may be complicated.

• ED&C, 5-FU, and cryotherapy are acceptable first-line agents for BD, given the available evidence.

• ED&C may be superior to cryotherapy for lower-leg lesions.

• There appears to be good evidence for the superior efficacy of red light over green light in ALA-PDT.

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