Actinic keratosis: Difference between revisions
No edit summary |
No edit summary |
||
| Line 7: | Line 7: | ||
{{Search infobox}} | {{Search infobox}} | ||
{{CMG}} | {{CMG}} | ||
{{SK}} Solar keratosis; AK | {{SK}} Solar keratosis; AK | ||
==Overview== | ==Overview== | ||
'''Actinic keratosis''' is a [[premalignant condition]] of thick, scaly, or crusty patches of skin. It is most common in fair-skinned people who are frequently exposed to the sun, because their pigment isn't very protective. It usually is accompanied by solar damage. Since some of these pre-cancers progress to [[squamous cell carcinoma]], they should be treated. | '''Actinic keratosis''' is a [[premalignant condition]] of thick, scaly, or crusty patches of skin. It is most common in fair-skinned people who are frequently exposed to the sun, because their pigment isn't very protective. It usually is accompanied by solar damage. Since some of these pre-cancers progress to [[squamous cell carcinoma]], they should be treated. | ||
==Pathophysiology== | ==Pathophysiology== | ||
When skin is exposed to the sun constantly, thick, scaly, or crusty bumps appear. The scaly or crusty part of the bump is dry and rough. The growths start out as flat scaly areas, and later grow into a tough, wart-like area. | When skin is exposed to the sun constantly, thick, scaly, or crusty bumps appear. The scaly or crusty part of the bump is dry and rough. The growths start out as flat scaly areas, and later grow into a tough, wart-like area. | ||
==Diagnosis== | ==Diagnosis== | ||
===Physical Examination=== | ===Physical Examination=== | ||
An actinic [[keratosis]] site commonly ranges in between 2 to 6 millimeters, and can be dark or light, tan, pink, red, a combination of all these, or the same pigment of one's skin. It may appear on any sun-exposed area, such as the face, ears, neck, scalp, chest, back of hands, forearms, lips etc. | An actinic [[keratosis]] site commonly ranges in between 2 to 6 millimeters, and can be dark or light, tan, pink, red, a combination of all these, or the same pigment of one's skin. It may appear on any sun-exposed area, such as the face, ears, neck, scalp, chest, back of hands, forearms, lips etc. | ||
===Other Diagnostic Studies=== | |||
===Other | |||
Doctors can usually identify AK by doing a thorough examination. A [[biopsy]] may be necessary when the keratosis is large and/or thick, to make sure that the bump is a keratosis and not a [[skin cancer]]. [[Seborrheic keratosis|Seborrheic keratoses]] are other bumps that appear in groups like the actinic keratosis but are not caused by sun exposure, and are not related to skin cancers. [[Seborrheic keratoses]] may be mistaken for an actinic keratosis. | Doctors can usually identify AK by doing a thorough examination. A [[biopsy]] may be necessary when the keratosis is large and/or thick, to make sure that the bump is a keratosis and not a [[skin cancer]]. [[Seborrheic keratosis|Seborrheic keratoses]] are other bumps that appear in groups like the actinic keratosis but are not caused by sun exposure, and are not related to skin cancers. [[Seborrheic keratoses]] may be mistaken for an actinic keratosis. | ||
== Treatment == | == Treatment == | ||
===Medical Therapy=== | ===Medical Therapy=== | ||
Various modalities are employed in the treatment of actinic keratosis: | Various modalities are employed in the treatment of actinic keratosis: | ||
* [[5-fluorouracil]] (a [[chemotherapy]] agent): A cream that contains this medication causes AKs to become red and [[inflamed]] before they fall off. | |||
* [[Photodynamic therapy]]: This new therapy involves application of a chemical on the skin, which makes AKs sensitive to specific wavelengths of light | |||
* [[Cauterization|Electrocautery]]: Burning off AKs with electricity. | |||
* [[Immunotherapy]]: Topical treatment with [[imiquimod]] (Aldara™), an immune enhancing agent | |||
===Surgery=== | |||
* [[Cryosurgery]], e.g. with [[liquid nitrogen]], by "freezing off" the AKs. | * [[Cryosurgery]], e.g. with [[liquid nitrogen]], by "freezing off" the AKs. | ||
* Different forms of [[surgery]]. | * Different forms of [[surgery]]. | ||
| Line 63: | Line 59: | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Revision as of 15:18, 12 March 2013
Template:DiseaseDisorder infobox Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Solar keratosis; AK
Overview
Actinic keratosis is a premalignant condition of thick, scaly, or crusty patches of skin. It is most common in fair-skinned people who are frequently exposed to the sun, because their pigment isn't very protective. It usually is accompanied by solar damage. Since some of these pre-cancers progress to squamous cell carcinoma, they should be treated.
Pathophysiology
When skin is exposed to the sun constantly, thick, scaly, or crusty bumps appear. The scaly or crusty part of the bump is dry and rough. The growths start out as flat scaly areas, and later grow into a tough, wart-like area.
Diagnosis
Physical Examination
An actinic keratosis site commonly ranges in between 2 to 6 millimeters, and can be dark or light, tan, pink, red, a combination of all these, or the same pigment of one's skin. It may appear on any sun-exposed area, such as the face, ears, neck, scalp, chest, back of hands, forearms, lips etc.
Other Diagnostic Studies
Doctors can usually identify AK by doing a thorough examination. A biopsy may be necessary when the keratosis is large and/or thick, to make sure that the bump is a keratosis and not a skin cancer. Seborrheic keratoses are other bumps that appear in groups like the actinic keratosis but are not caused by sun exposure, and are not related to skin cancers. Seborrheic keratoses may be mistaken for an actinic keratosis.
Treatment
Medical Therapy
Various modalities are employed in the treatment of actinic keratosis:
- 5-fluorouracil (a chemotherapy agent): A cream that contains this medication causes AKs to become red and inflamed before they fall off.
- Photodynamic therapy: This new therapy involves application of a chemical on the skin, which makes AKs sensitive to specific wavelengths of light
- Electrocautery: Burning off AKs with electricity.
- Immunotherapy: Topical treatment with imiquimod (Aldara™), an immune enhancing agent
Surgery
- Cryosurgery, e.g. with liquid nitrogen, by "freezing off" the AKs.
- Different forms of surgery.
Regular follow-up after treatment is advised by many doctors. The regular checks are to make sure new bumps have not developed and that old ones haven't become thicker and/or have skin disease.
Primary Prevention
Preventative measures recommended for AK are similar to those for skin cancer:
- Not staying in the sun for long periods of time without protection (e.g.:sunscreen, clothing, hats).
- Frequently applying powerful sunscreens with SPF ratings greater than 15 and that also block both UVA andUVB light.
- Using sunscreen even in winter sun exposure.
- Wearing sun protective clothing such as hats, long-sleeved shirts, long skirts, or pants.
- Avoiding sun exposure during noon hours is very helpful because ultraviolet light is the most powerful at that time.
Future or Investigational Therapies
As of 2008 a company in Australia named Clinuvel Pharmaceuticals Limited is performing clinical trials with a melanocyte-stimulating hormone named melanotan (which they refer to as CUV1647) for actinic keratosis in organ transplant patients.[1]
External Links
- American Academy of Dermatology
- American Osteopathic College of Dermatology
- National Library of Medicine and the National Institute of Health
- Actinic Keratosis photo library at Dermnet
- Medicinenet's article on Actinic Keratosis
- Information on Actinic Keratosis from The Skin Cancer Foundation