biostudies-literatureBernal Masferrer LInstituto de Salud Carlos III Ministerio de Ciencia e innovación and Feder FundsInstituto de Salud Carlos III Ministerio de Ciencia e innovación, Feder Funds (FIS PI21/00953 and PI21/00315) and the Research Group of the Government of Aragon B59-23D Dermatología y Fotobiología.Research Group of the Government of Aragon B59-23D Dermatología y Fotobiología1133https://www.ebi.ac.uk/biostudies/studies/S-EPMC10969398biostudies-literatureUnknown16(6)This comprehensive review delves into various immunotherapeutic approaches for the management of actinic keratoses (AKs), precancerous skin lesions associated with UV exposure. Although there are treatments whose main mechanism of action is immune modulation, such as imiquimod or diclofenac, other treatments, apart from their main effect on dysplastic cells, exert some immunological action, which in the end contributes to their efficacy. While treatments like 5-fluorouracil, imiquimod, photodynamic therapy, and nicotinamide are promising in the management of AKs, especially in immunocompetent individuals, their efficacy is somewhat reduced in solid organ transplant recipients due to immunosuppression. The analysis extends to optimal combination, focusing on cryoimmunotherapy as the most relevant. New immunotherapies include resimiquimod, ingenol disoxate, N-phosphonacetyl-L-aspartate (PALA), or anti-PD1 that have shown promising results, although more studies are needed in order to standardize their use.CancersTopical Immunotherapy for Actinic Keratosis and Field Cancerization.PMC10969398PI21/00315FIS PI21/00953Instituto de Salud Carlos III Ministerio de Ciencia e innovación, Feder Funds (FIS PI21/00953 and PI21/00315) and the Research Group of the Government of Aragon B59-23D Dermatología y Fotobiología.Juarranz de la Fuente AGilaberte YAlmenara Blasco MGallego Rentero MBernal Masferrer LBernad Alonso IGracia Cazana TAlvarez-Salafranca MfalseTopical Immunotherapy for Actinic Keratosis and Field Cancerization.This comprehensive review delves into various immunotherapeutic approaches for the management of actinic keratoses (AKs), precancerous skin lesions associated with UV exposure. Although there are treatments whose main mechanism of action is immune modulation, such as imiquimod or diclofenac, other treatments, apart from their main effect on dysplastic cells, exert some immunological action, which in the end contributes to their efficacy. While treatments like 5-fluorouracil, imiquimod, photodynamic therapy, and nicotinamide are promising in the management of AKs, especially in immunocompetent individuals, their efficacy is somewhat reduced in solid organ transplant recipients due to immunosuppression. The analysis extends to optimal combination, focusing on cryoimmunotherapy as the most relevant. New immunotherapies include resimiquimod, ingenol disoxate, N-phosphonacetyl-L-aspartate (PALA), or anti-PD1 that have shown promising results, although more studies are needed in order to standardize their use.2024-01-01T00:00:00Z2024 Mar2025-04-21T21:28:19.783Z2025-04-05T18:25:48.009ZS-EPMC109693983853946810.3390/cancers16061133