Therapeutic Induction of Dermal Remodeling in Veterans to Prevent Actinic Neoplasia Caused by Chronic Environmental Exposure to Ultraviolet Radiation
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Microneedling, Trichloroacetic acid peel.
- Who it may be relevant to
- Registry conditions: Nonmelanoma Skin Cancer, Actinic Keratosis. Basic parameters: from 60 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The investigators' previous studies demonstrate geriatric subject skin responds differently to ultraviolet B (UVB) light compared to young subject skin, which contribute to increased rates of nonmelanoma skin cancer (NMSC) and actinic keratosis (AK) development in geriatric populations. Previously, the investigators have shown that therapeutic dermal remodeling interventions (e.g., fractionated laser resurfacing and microneedling) can restore appropriate skin responses to UVB in geriatric skin. The investigators also demonstrated fractionated laser resurfacing (FLR) reduced rates of NMSC and AK development (compared to untreated control skin) in at risk geriatric subjects. This interventional study will assess the ability of two therapeutic dermal remodeling therapies, microneedling and trichloroacetic acid chemical (TCA) peel, to impact NMSC and AK development in at risk geriatric subjects. Geriatric subjects will be enrolled into one of two study groups. In the first group, one arm will be treated with microneedling and the other arm will not be treated on day 1. In the second group, one arm will be treated with TCA peel and the other arm will not be treated on day 1. Subjects will subsequently be monitored for number of NMSC and AK on treated and untreated (control) forearms in each group. In addition to monitoring NMSC and AK development, subjects at the Richard L. Roudebush VAMC will undergo skin punch biopsy at one of their follow up visits for microscopic and molecular analyses of treated and untreated skin.
Interventions
- Other Microneedling
Microneedling- a mechanical tool that makes tiny holes in a superficial part of the skin - Other Trichloroacetic acid peel
Trichloroacetic acid peel that removes a superficial part of the skin
Primary outcome measures
- Change From Baseline in the Number of Actinic Keratosis due to treatment. [Time frame: up to 4 years]
- Change From Baseline in the Number Non-Melanoma Skin Cancers due to treatment. [Time frame: up to 4 years]
Eligibility criteria
Inclusion criteria
- Adult Males and Females age 60 and older with 5 or more AKs on each forearm
- Skin type fair-Fitzpatrick I-II
- Able to comprehend procedures and risks
Exclusion criteria
- More than 10 AKs on an extremity, or AKs that are large (2-3+)
- Medical history of Diabetes
- Coagulopathy or easy bleeding
- History of poor wound healing or scarring
- Large tattoos that can interfere with study
- Other serious health issues and other skin diseases that could interfere with the study
- Recent (within 1 year) field therapies such as Efudex cream or PDT to forearms
- Planning to leave region in next 4 years
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Prevention
Study locations
United States · 2 centers
- Richard L. Roudebush VA Medical Center, Indianapolis, IN — Indianapolis
- Dayton VA Medical Center, Dayton, OH — Dayton
Identifiers
NCT: NCT07648407 · ONCE-003-25S · RD001084