Related articles: Actinic keratosis
Definition
Actinic keratosis is a benign lesion of the skin, a consequence of the cumulative effect of sun exposure. The disease, in fact, arises with increasing age, especially after the age of 40.
Actinic keratosis is considered a pre-cancerous lesion, therefore it can degenerate and give rise to skin tumors. Subjects with a clear phototype (phototype 1-2: blond or red hair, blue or green eyes) are particularly predisposed to develop actinic keratoses. The risk is also increased for people who, for professional reasons (eg unskilled workers, fishermen or peasants) or lifestyle, are subjected to intense exposure to the sun. Actinic keratosis may also depend on excessive artificial tanning or exposure to UVA, X-rays or specific chemicals.
Most common symptoms and signs *
- calli
- Keratosis
- Erythema
- papules
- Dry skin
- plaques
- itch
- Scales on the skin
- Telangiectasia
Further indications
Actinic keratosis initially appears as a small papule or erythematous plaque covered with dry and rough scales to the touch. The lesions that appear on the surface of the skin are in relief, with poorly defined margins and surrounded by a red halo and telangiectasias. The keratoses can be pink or red, yellowish or light gray, and reach a diameter of 1-2.5 cm or more. Lesions can cause a feeling of itching and burning, but can also be asymptomatic. The most affected sites are the photoexposed ones: head (especially auricles and forehead), legs, arms, back of the hands, anterior and posterior trunk. The bald subjects suffer especially on the scalp.
The diagnosis is clinical, sometimes supported by a biopsy. The differential diagnosis is placed with respect to seborrheic keratoses, whose lesions, although similar to actinic keratoses, tend to appear waxy and with clear margins. Furthermore, unlike actinic keratoses, seborrheic lesions can also appear on areas of the body that are not exposed to the sun and are not pre-cancerous.
Actinic keratoses must be treated to prevent malignant evolution. There are various treatment options, depending on their number and location. These include the removal of the lesion (with classical surgery, cryotherapy or laser), photodynamic therapy or topical therapies based on antiblastic or immunomodulating drugs.
