Treatment of Pre-Cancers ie Actinic Keratoses
What is an actinic keratosis?
An actinic keratosis is a precancerous scaly spot found on sun-damaged skin, also known as solar keratosis. It may be considered an early form of cutaneous squamous cell carcinoma (a keratinocyte cancer).
Who gets actinic keratoses?
Actinic keratoses affect people that have often lived in the tropics or subtropics and have predisposing factors such as:
- Other signs of photoageing skin
- Fair skin with a history of sunburn
- History of long hours spent outdoors for work or recreation
- Defective immune system.
However, even in other climates they may be common – in southern Ireland and northwest England up to 25% of people aged 60 years and over have at least one.
What causes actinic keratoses?
Actinic keratoses are the result of abnormal skin cell development due to DNA damage by short wavelength UVB.
They are more likely if the immune function is poor, due to ageing, recent sun exposure, predisposing disease, or certain drugs.
What does actinic keratosis look like?
Actinic keratosis may be single but there are often multiple lesions at once. The appearance may be different even in the same person.
- A flat or thickened area of skin
- White or yellow, scaly, warty, or horny surface
- Skin may coloured red or be pigmented
- Tender to touch or painless
They are sometimes graded 1-4 depending on their appearance.
What causes actinic keratoses?
Actinic keratoses are the result of abnormal skin cell development due to DNA damage by short wavelength UVB.
They are more likely if the immune function is poor, due to ageing, recent sun exposure, predisposing disease, or certain drugs.
What does actinic keratosis look like?
Actinic keratosis may be single but there are often multiple lesions at once. The appearance may be different even in the same person.
- A flat or thickened area of skin
- White or yellow, scaly, warty, or horny surface
- Skin may coloured red or be pigmented
- Tender to touch or painless
They are sometimes graded 1-4 depending on their appearance.
Actinic keratoses are very common on sites regularly exposed to the sun, especially
- the backs of the hands and
- the face, most often affecting
- the ears, nose, cheeks, upper lip, lower lip, temples, forehead, and balding scalp.
In severely chronically sun-damaged individuals, they may also be found on
- the upper trunk,
- upper and lower limbs, and
- On the tops of feet.
What is an actinic keratosis?
An actinic keratosis is a precancerous scaly spot found on sun-damaged skin, also known as solar keratosis. It may be considered an early form of cutaneous squamous cell carcinoma (a keratinocyte cancer).
Who gets actinic keratoses?
Actinic keratoses affect people that have often lived in the tropics or subtropics and have predisposing factors such as:
- Other signs of photoageing skin
- Fair skin with a history of sunburn
- History of long hours spent outdoors for work or recreation
- Defective immune system.
However, even in other climates they may be common – in southern Ireland and northwest England up to 25% of people aged 60 years and over have at least one.
What causes actinic keratoses?
Actinic keratoses are the result of abnormal skin cell development due to DNA damage by short wavelength UVB.
They are more likely if the immune function is poor, due to ageing, recent sun exposure, predisposing disease, or certain drugs.
What does actinic keratosis look like?
Actinic keratosis may be single but there are often multiple lesions at once. The appearance may be different even in the same person.
- A flat or thickened area of skin
- White or yellow, scaly, warty, or horny surface
- Skin may coloured red or be pigmented
- Tender to touch or painless
They are sometimes graded 1-4 depending on their appearance.
Actinic keratoses are very common on sites regularly exposed to the sun, especially
- the backs of the hands and
- the face, most often affecting
- the ears, nose, cheeks, upper lip, lower lip, temples, forehead, and balding scalp.
In severely chronically sun-damaged individuals, they may also be found on
- the upper trunk,
- upper and lower limbs, and
- On the tops of feet.
Should I worry if I have AKs?
The main concern is that actinic keratoses indicate an increased risk of developing squamous cell carcinoma.
It is rare for a solitary actinic keratosis to evolve to squamous cell carcinoma (SCC), but the risk of SCC occurring at some stage in a patient with more than 10 actinic keratoses is thought to be about 10 to 15%.
A tender, thickened, or enlarging AK is suspicious of evolution to SCC.
A horn may arise from an underlying actinic keratosis or SCC.
Because they are sun damaged, people with actinic keratoses are also at risk of developing other conditions such as actinic cheilitis (AK of the lips), basal cell carcinoma (BCC, which is more common than SCC), melanoma, and rarer forms of skin cancer.