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Home :: Skin Disorders

Actinic Keratosis - Definition, Causes, Symptoms and Treatment


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Actinic keratosis, also known as solar keratosis, is the most common precancerous lesion of the skin. Actinic keratoses are directly related to the amount of sun exposure one has had over a lifetime. The cumulative cell damage caused by sun exposure eventually causes mutations in the skin cell DNA, thus causing precancerous or cancerous lesions. They range in size from as small as a pinhead to over an inch across. They may be light or dark, tan, pink, red, a combination of these, or the same color as ones skin. The scale or crust is horn-like, dry, and rough, and is often recognized easier by touch rather than sight. Actinic keratosis may appear as early as 30 years of age in susceptible people who spend a lot of time outdoors. People with skin phototypes I and II are more likely to be affected, as are albinos and Immunosuppressed patients. Actinic keratosis arise on fair-skinned people in areas of long-term sun exposure, such as the face, ears, bald scalp, forearms, and backs of the hands.

Actinic keratosis is most often diagnosed clinically and treated accordingly. When the possibility of cancer exists, a skin biopsy is obtained. Because more than half of an average person's lifetime sun exposure occurs before the age of 20, keratoses appear even in people in their early twenties who have spent too much time in the sun. Actinic keratosis on the lower lip presents as diffuse chapping that does not resolve, despite liberal use of petroleum jelly or lip balms. Certain genetic disorders result in increased sun sensitivity or decreased ability to repair cell damage. These individuals have a greater propensity for developing premalignancies and malignancies of the skin. The most common treatment for actinic keratosis is cryosurgery. A very cold substance, liquid nitrogen, is applied locally to the lesion. Curettage and electrodesiccation, a "scrape and burn" technique, is sometimes used, particularly for a single, thick, or hornlike lesion.

Causes of Actinic keratosis

There are several factors known to cause actinic keratosis. Probably the most important factor is the genetically defined individual skin type. Actinic keratosis occurs most commonly in fair skin, especially in the elderly and in young individuals with light complexions. The growths occur in sun-exposed skin areas. Anyone can develop sun damage regardless of race. Obviously the lighter your skin tone, the more likely you are to get sun burned and develop AKs. Actinic keratosis can also emerge from exposure to cancer-causing substances such as arsenic, X-ray radiation.

Common causes and risk factors of Actinic keratosis:

  • A history of frequent or intense sun exposure or sunburn.
  • Pale skin.
  • A tendency to freckle or burn when exposed to sunlight.
  • Exposure to cancer-causing substances such as arsenic, X-ray radiation.

Signs and Symptoms of Actinic keratosis

Actinic keratoses are small red, brown, or skin-colored patches. Actinic keratoses commonly occur on the head, neck, or hands but can be found on other areas of the body. They needs to be evaluated by a health professional, especially if the keratoses become painful, bleed, become open sores, become infected, or increase in size.

Sign and symptoms may include the following:

  • Rough and dry textured skin lesion.
  • Mole that grows or otherwise changes its appearance.
  • Lesions on your skin ranging in color from pink to red to brown, or flesh-colored.
  • Sore that begins oozing or bleeding.

Treatment for Actinic keratosis

There are a number of effective treatments for eradicating actinic keratoses. Not all keratoses need to be removed. Options for the treatment of actinic keratosis include topical drug therapy, surgical or chemical destruction of the lesions and photodynamic therapy. Cryosurgery, one of the most common treatments done, freezes off lesions through application of liquid nitrogen. This is done with a special spray device or cotton-tipped applicator. It does not require anesthesia and produces no bleeding. Curettage is another treatment. The physician scrapes the lesion and may take a biopsy specimen to be tested for malignancy. More recently, lasers and other light sources have been used to treat actinic keratoses.

Treatment may include:

  • Cryosurgery, e.g. with liquid nitrogen.
  • Fluorouracil, a medication that you put directly on the keratoses.
  • Lasers and other light sources have been used to treat actinic keratoses.
  • A chemical is applied to the affected area and then treating with the correct wavelength of visible light. This treatment is available in certain centres.
  • Patient administered cream that triggers an immune response.
  • Topical medications are also effective in completely eradicating actinic keratosis.