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CLINICAL REPORT
A Novel Actinic Keratosis Field Assessment Scale for Grading
Actinic Keratosis Disease Severity
Brigitte DRÉNO 1 , Rino CERIO 2 , Thomas DIRSCHKA 3 , Ignasi FIGUERAS NART 4 , John T. LEAR 5 , Ketty PERIS 6 , Andrés RUIZ
DE CASAS 7 , Shaniko KALECI 8 and Giovanni PELLACANI 9 ; Progressing Evidence in AK (PEAK) Working Group
Department of Dermato Cancerology, University of Nantes, Nantes, France, 2 Department of Cutaneous Medicine and Surgery, The Royal
London Hospital and QMUL, Bart’s Health NHS Trust, London, UK, 3 CentroDerm ® Clinic, Wuppertal, and Faculty of Health, University Witten-
Herdecke, Witten, Germany, 4 Department of Dermatology, Bellvitge Hospital, Barcelona, Spain, 5 Manchester Academic Health Science Centre,
MAHSC, Manchester University and Salford Royal NHS Foundation Trust, Royal Infirmary, The University of Manchester, Manchester, UK,
6
Department of Dermatology, Catholic University of Rome, Rome, Italy, 7 Dermatology Unit, Virgen Macarena University Hospital, Seville,
Spain, 8 Statistics Unit, Department of Diagnostic Medicine, Clinical and Public Health, and 9 Department of Dermatology, University of Modena
and Reggio Emilia, Modena, Italy
1
Actinic keratosis (AK) lesions are surrounded by field
cancerization (areas of subclinical, non-visible sun da-
mage). Existing AK grading tools rely on AK counts,
which are not reproducible. An Actinic Keratosis Field
Assessment Scale (AK-FAS) for grading the severity
of AK/field was developed. Standardized photographs
of patients representing the full range