is Actinic Keratosis a cancer ? - Human & Disease

is Actinic Keratosis a cancer ?


Actinic Keratosis

Actinic Keratosis Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. An actinic keratosis is a rough, scaly patch on the skin that develops from years of sun exposure. Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun,They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don't know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions.
Actinic keratosis









Actinic keratosis are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. An actinic keratosis is a rough, scaly patch on the skin that develops from years of sun exposure.

Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun,They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don't know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions.

History:

¤ also called solar keratosis, senile keratosis

¤ This disorder is the earliest clinical manifestation of squamous cell carcinoma

¤ disease of the older adult with chronic sun-damaged skin

¤ Risk factors: fair skin, blue eyes, red or blonde hair, years of ultraviolet radiation exposure through work (e.g., farmers, mail carriers, etc.) or through leisure activities (tanning bed use, tanning)

¤ Patients who are organ transplant recipients are prone to developing many actinic keratoses, and malignant transformation (progression) is much more common in this setting.

Actinic Keratosis Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. An actinic keratosis is a rough, scaly patch on the skin that develops from years of sun exposure. Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun,They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don't know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions.









¤ sun-exposed distribution most often on the head, neck, forearms or dorsal hands of men, and these areas plus the legs in women.

¤ poorly circumscribed erythematous macules, papules, or plaques,several millimeters to a centimeter in diameter adherent, “sandpaper-like” scale

¤ may form a hypertrophic, verrucous surface and become a horn

¤ occasionally hyperpigmented

¤ may be tender

Tests:

¤ The diagnosis is clinical.

¤ If the diagnosis is in question, a biopsy may be performed.

differential diagnosis
¤ Bowen’s disease (squamous cell cancer in situ)

¤ Squamous cell cancer

¤ Basal cell cancer

¤ Seborrheic keratosis-sharp demarcation, stuck on appearance.

Actinic Keratosis Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. An actinic keratosis is a rough, scaly patch on the skin that develops from years of sun exposure. Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun,They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don't know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions.






Management


¤ Suncreens, sun protective clothing and alteration of behavior lessen the chance of development of new lesions.

¤ Low-fat diet may also result in a lower rate of appearance of new lesions.

¤ Smoking cessation.


What is the most effective treatment for actinic keratosis?

Actinic keratoses can be removed by freezing them with liquid nitrogen. Your health care provider applies the substance to the affected skin, which causes blistering or peeling. As your skin heals, the damaged cells slough off, allowing new skin to appear. 

Cryotherapy is the most common treatment.

Specific therapy:

¤ Liquid nitrogen application (destructive)

¤ Curettage with desiccation

¤ topical application

° 5-Fluorouracil

° imiquimod

° diclofenac

° tretinoin

¤ Photodynamic therapy

Actinic keratosis are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. An actinic keratosis is a rough, scaly patch on the skin that develops from years of sun exposure. Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun,They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don't know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions.










Follow-up:

¤ 6–8 weeks after therapy the patient should be re-examined.

¤ 6 months to 1 year for treatment response and examination for new lesions.

Actinic Keratosis Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. An actinic keratosis is a rough, scaly patch on the skin that develops from years of sun exposure. Actinic keratosis is an abnormal growth of cells caused by long-term damage from the sun,They are not cancerous, but a small fraction of them will develop into skin cancer. Because we don't know which ones will become cancer and which will not, dermatologists recommend treatment of these lesions.







Do actinic keratosis need to be removed?

Actinic keratoses do not necessarily need to be surgically removed. They can be treated by the application of gels and creams such as fluorouracil, imiquimod, ingenol mebutate or diclofenac. These topical applications are most effective if there are several closely spaced lesions on the skin.


What is the best way to remove actinic keratosis?

First your doctor will numb the area and then use a scalpel blade to remove the growth. Sometimes shaving or scraping is used along with cryosurgery to treat thinner or flat growths. Burning with an electric current (electrocautery). First your doctor will numb the area and then destroy the growth with electrocautery.


What vitamin treats actinic keratosis?

Vitamin B3 (Niacin, Nicotinamide)
The evidence is stronger that it significantly reduces the risk of developing the more mild skin cancers of Basal Cell Carcinoma, Squamous Cell Carcinoma and even reduce precancerous lesions of Actinic Keratosis.


What sunscreen is good for sctininc keratosis?

Skin cancer prevention and adjunctive treatment to actinic keratosis requires consistent and adequate sun protection. For that reason, choose a light, fluid application like Eucerin Actinic Control MD SPF 100.


Complications and prognosis:


¤ patient population is prone to develop new lesions despite avoidance of further ultraviolet exposure

¤ estimated 10% chance of at least one lesion developing into squamous cell cancer after 10 years if left untreated.

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