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Actinic Keratosis - actinic keratosis picture, treatment

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.

Actinic Keratosis Picture

Alternative Names of Actinic Keratosis (Ak)

1. Solar keratosis;
2. Sun-induced skin changes - keratosis;
3. Keratosis - actinic (solar)
4. senile keratosis

Symptoms of Actinic Keratosis

• Rough and dry textured skin lesion
• A macule, patch, or growth on the skin
• Limited to a discrete area (localized)
• Located on the face, scalp, back of the hands, chest or other sun-exposed areas
• Color gray, pink, red (erythematous), or the same color as the skin
• Surface is initially flat and scaly, then becomes slightly raised
• Surface texture becomes hard and wart-like or gritty, rough, and "sandpapery"; may develop a horn-like texture from overgrowth of skin keratin layer (hyperkeratosis).

Cause of Actinic Keratosis

A predisposition for solar keratosis is genetic. They occur more frequently in fair, redheaded, or blonde patients that burn frequently and tan poorly.

• Long periods of sun exposure
• History of kidney or other solid organ transplant (people who take medicines that suppress the immune system)
• Light-skinned individuals, the very young, and the elderly are at risk.
• Having fair skin, blue or green eyes, or blond or red hair
• Multiple, severe sunburns early in life

Signs and tests for Actinic Keratosis

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.

• Presence of atypical keratinocytes in the reticular dermis.
• Independent nests of keratinocyte.

What are the treatments of Actinic Keratosis?

When an AK is diagnosed, dermatologists consider a number of factors before choosing the most appropriate treatment method. Factors include:

• Size, number, location, and stage of the lesions
• Age, health, and medical history
• Occupation
• Cosmetic expectations and treatment preferences
• Patient compliance (i.e., willingness to self-treat as needed for several weeks)
• History of previous treatment

Because actinic keratoses represent precancerous changes, have them examined promptly, and follow the health care provider's advice for treatment.

• Growths may be removed by cryotherapy (freezing), electrical cautery (burning), or surgery. Growths may also be treated with topical medications that cause peeling or skin removal.
• An actinic keratosis is usually treated by liquid-nitrogen cryotherapy. Persistent, recurrent, or hypertrophic actinic keratoses may be removed by surgical excision or removed by scalpel with biopsy and curettage.
• Chemical peels
• Cutting the tumor out and using stitches to place the skin back together (called excision)
  
• Creams such as 5-fluorouracil (5-FU) and imiquimod
• Shave Removal utilizes a scalpel to shave the keratosis and obtain a specimen for testing. The base of the lesion is destroyed, and the bleeding is stopped by cauterization.
  

How to get rid of Actinic Keratosis

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.

Photodynamic Therapy (PDT) for Actinic Keratosis

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.

Prevention of Actinic Keratosis

• Wear long sleeves, pants, a wide-brimmed hat, and sunglasses that protect against both UVA and UVB rays.
• Frequently applying powerful sunscreens with SPF ratings greater than 30 and that also block both UVA and UVB light.
• Get vitamin D safely through a healthy diet that includes vitamin supplements. Don’t seek the sun.
• Not staying in the sun for long periods of time without protection (e.g., sunscreen, clothing, hats).
• Ultraviolet light from the sun and tanning beds causes skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product. When using a self-tanning product, you should continue to use sunscreen.
  

Also check out Pigmented solar keratosis and Seborrheic Dermatitis, keratoacanthoma, sebaceous hyperplasia

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