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Aactinic keratosis (AK) is commonly known as a solar keratosis. It occurs in all age groups and is characterised by a small, rough spot occurring on skin that has been chronically exposed to the sun. Actinic keratoses generally measure in size between 2 to 6 millimeters in diameter (between the size of a pencil point to that of an eraser). They are usually reddish in color and often have a white scale on top.
Actinic keratosis is the most common sun-related growth. An estimated 60% of individuals older than 40 years who are predisposed have at least one actinic keratosis or solar keratosis. Usually, these people are fair-skinned, burn easily, and tan poorly, as well as have occupations or hobbies that result in excessive sun exposure. Many people have new actinic keratoses each year. It may appear on any sun-exposed area, such as the face, ears, neck, scalp, chest, backs of hands, forearms, or lips.
A predisposition for solar keratosis is genetic. They occur more frequently in fair, redheaded, or blonde patients that burn frequently and tan poorly.
The health care provider makes the diagnosis based on the appearance of the skin growth. A skin biopsy may be done for larger and thicker actinic keratoses to make sure no cancer is present.
Differential diagnosis includes superficial squamous cell carcinoma.
When an AK is diagnosed, dermatologists consider a number of factors before choosing the most appropriate treatment method. Factors include:
Because actinic keratoses represent precancerous changes, have them examined promptly, and follow the health care provider's advice for treatment.
Trichloroacetic acid or other caustic agents may provide an alternative way to treat patients with extensive actinic keratoses. The excision of actinic keratoses is occasionally a useful and definitive treatment in selected lesions. In lesions suspected of being invasive squamous cell carcinomas, excision may have an advantage in establishing a diagnosis as well as effectively treating the lesion. The wound can be closed primarily or allowed to heal by second intention.
PDT may be used to treat lesions on the face and scalp. Topical 5-aminolevulinic acid (5-ALA) is applied to the lesions by the physician. The next day, the medicated areas are exposed to strong light, which activates the 5-ALA. The treatment selectively destroys actinic keratoses, causing little damage to surrounding normal skin, although some swelling often occurs. Common forms of AK are shown here in the sites where they most often develop. Examine your skin regularly for any lesions that look like them. If you ever spot these or any other suspicious or changing growths , see your doctor promptly.
In conclusion, large, multiple or inflamed actinic keratosis need to be treated to prevent their conversion to squamous cell carcinoma. This avoids the potentially more invasive and extensive treatment of a subsequent malignancy. Regular follow-up visits are usually needed when there are many keratoses.
Also check out Pigmented solar keratosis and Seborrheic Dermatitis, keratoacanthoma, sebaceous hyperplasia
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