Date of Graduation

Summer 8-13-2016

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Annjanette Sommers, PA-C, MS

Second Advisor

Jennifer Van Atta, PA-C, MS

Abstract

Background: Actinic keratoses (AKs) are skin lesions primarily caused by ultraviolet (UV) exposure. They are precancerous lesions and can develop into non-melanoma skin cancer. Exposure to UV radiation leads to the development of AKs by several mechanisms. UV radiation damages cellular DNA, depletes cellular energy levels, and suppresses the immune system. Nicotinamide is a form of vitamin B3. Topical nicotinamide increases cellular energy levels and protects against immunosupression in humans. The question arises, could oral nicotinamide mitigate the harmful effects of UV radiation, and be useful in the reduction of AKs?

Methods: An exhaustive literature search was conducted using MEDLINE - Ovid, Web of Science, and Google Scholar. The search terms nicotinamide and actinic keratosis were used. Applicable articles were assessed for quality using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Results:Two studies met eligibility criteria and were included. Both were randomized, controlled, double-blinded trials. One trial included two cohorts, with different doses of nicotinamide used. Cohort 1 found that the number of AKs were 35% less in the nicotinamide group at 2 months (95% confidence interval (CI): 23-45%; p

Conclusion: The two studies reviewed demonstrated a reduction in AKs in patients taking oral nicotinamide. Providers should consider oral nicotinamide supplementation in patients with sun-damaged skin. Further research is needed to explore the action of nicotinamide on the prevention of AKs and NMSC.

Keywords: Nicotinamide and actinic keratoses

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