Solar keratoses: analysis in a dermatological practice in Australia

Area of Science:

• Dermatology
• Oncology
• Epidemiology

Background:

• Solar keratoses (SK) are common pre-malignant skin lesions.
• Understanding the prevalence and associated skin cancers in SK patients is crucial for early detection and management.

Purpose of the Study:

• To quantify the burden of solar keratoses in a clinical cohort.
• To determine the incidence of non-melanoma skin cancer (NMSC) in patients with SK.
• To analyze the distribution and types of skin cancers associated with SK.

Main Methods:

• Retrospective analysis of 200 consecutive patients diagnosed with SK in a private dermatology practice.
• Data collection included lesion counts, presence and type of NMSC, and lesion site.
• Comparison of SK lesion counts with general population data.

Main Results:

• Patients presented with an average of 61.9 SK lesions, significantly higher than the general population average of 8.
• 41% of patients had co-existing NMSC, with 17% having squamous cell carcinoma (SCC).
• The ratio of basal cell carcinoma (BCC) to SCC was 1.7:1. SK lesions were most common on upper limbs, but densest on the face. SCCs were frequent on limbs, while BCCs were common on the head and neck.

Conclusions:

• Patients with solar keratoses represent a high-risk group for developing non-melanoma skin cancers.
• The high prevalence of SK and associated NMSC underscores the need for vigilant monitoring and treatment in dermatology practices.
• Topical treatments and preventative measures are essential for managing SK and reducing the risk of malignant transformation.