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Actinic Keratoses

Actinic keratoses (singular: actinic kertosis), also known as solar keratoses, are precancerous scaly spots found on sun-damaged skin. They often develop into squamous cell carcinomas.

Actinic Keratoses

1. Actinic keratoses (AKs) are pre-cancers

Scaly or crusty in appearance, these spots develop slowly and are usually are a sign of long-term sun damage. They are most often found in areas of the skin generally exposed to the sun such as the scalp, the face, the neck, ears, arms, and shoulders.

2. Some people are predisposed to AKs

Actinic keratoses often affect people that have lived in the tropics or subtropics and/or have predisposing factors such as:

  • Other signs of sun damage on the skin

  • Fair skin

  • History of sunburn

  • History of long hours spent outdoors for work or recreation

  • Compromised immune system.

3. AKs are caused by sun damage

Sunlight contains ultraviolet radiation (UV). This is present in two forms -

  • Ultraviolet A (UVA) which has a longer wavelength, and is associated with skin aging

  • Ultraviolet B (UVB) has a shorter wavelength and is associated with skin burning.

AKs are caused by DNA damage in skin cells due to shorter-length UVB radiation. They are more likely to appear if the immune function is poor, due to ageing, recent sun exposure, existing predisposing diseases or certain medications.

4. Diagnosis is relatively straightforward

With the help of dermascopy, a board-certified dermatologist can diagnose one or more AK during a skin examination. A biopsy may be performed. The main concern with AKs is their tendency to develop into more serious squamous cell carcinomas (SCCs). While only about 8 to 10 percent of actinic keratoses will eventually become cancerous, the majority of SCCs do begin as AKs. Unfortunately, there’s no way to tell which AKs will become dangerous, so monitoring and treating any that crop up is the only way to be sure. AKs are also unsightly or may make patients uncomfortable.

Physician examining skin using a dermatoscope

5. Various treatments are available

Treatment generally involves cryotherapy to remove the damaged skin cells, which are generally located in the epidermis layer. Epidermis regenerates from surrounding cells that have not suffered sun damage. Other treatments can involve surgical excision (cutting and removing), chemical peels, or cauterizing (burning). The choice of treatment depends upon the size of the cancer, its location, how long you have had the tumor and how much scarring is likely to occur with each treatment.

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