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Current perspective on actinic keratosis: a review
J A Siegel1,2, K Korgavkar1,2, M A Weinstock1,2
1Center for Dermatoepidemiology-111D, Veterans Affairs Medical Center, Providence, RI, U.S.A.
The British Journal of Dermatology
|August 9, 2016
Summary
Actinic keratoses (AKs) are common skin lesions from sun exposure with unclear definitions and variable progression to squamous cell carcinoma (SCC). Improved AK definition and management are crucial for patient health and accurate diagnosis.
Area of Science:
- Dermatology
- Oncology
- Epidemiology
Background:
- Actinic keratoses (AKs) are prevalent, costly skin lesions linked to sun exposure.
- There is no universal definition for AKs, leading to diagnostic challenges.
- AKs represent epidermal keratinocytic dysplasia with potential progression to squamous cell carcinoma (SCC).
Purpose of the Study:
- To review the current understanding of Actinic keratoses (AKs).
- To discuss the diagnostic challenges and treatment efficacy of AKs.
- To highlight the importance of AK definition for managing keratinocytic carcinoma (KC) risk.
Main Methods:
- Literature review on AK definition, prevalence, progression, and treatment.
- Analysis of AK to SCC progression rates and spontaneous regression.
- Evaluation of current treatment options and their cosmetic outcomes.
Main Results:
- AK prevalence is high, with significant healthcare costs.
- AK to SCC progression rates are low (0.6% annually in high-risk groups), but regression is common, though lesions may reappear.
- 5-fluorouracil, imiquimod, and photodynamic therapy are discussed for AK treatment, with varying efficacy and cosmetic results.
Conclusions:
- Disagreement on AK definition complicates management and diagnosis.
- Treatments for AKs aim to improve appearance, relieve symptoms, and reduce KC risk.
- Improved clinician agreement on AK definition is needed for better patient health outcomes and accurate KC diagnosis.
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