[Efficacy of topical tirbanibulin in treating grade 2 actinic keratosis.]

Actinic keratoses (AK) are common precancerous lesions usually arising on chronic sun-exposed areas. Field of cancerization (FC) is a chronically UV-exposed area in which subclinical multifocal AKs are found. Therapeutic choice is mainly made according to the Olsen grade of AKs. We report the case of a 76-year-old man with numerous AKs of the face and scalp. The patient had undergone numerous topical physical and medical therapies with poor results. On the left cheek, grade I and grade II AKs were found in a large FC, so he was prescribed topical therapy with tirbanibulin 1% ointment. After 10 days erythema and crusts were objectified and a burning sensation was reported on the area of application and on surrounding areas. At 8 weeks follow-up, the patient had total resolution of disease and no residual local side effects. Although tirbanibulin 1% ointment has indication for type I AKs of face and scalp, this case reported its efficacy and benefit also on type II AKs, demonstrating safety and a minimal and manageable degree of discomfort caused to the patient. Therefore, it fits fully among the treatments of grade I AKs but numerous still may be its indications as demonstrated in our case, where efficacy, safety and compliance were combined.