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Actinic keratosis, Symptoms, Treatment of Actinic keratosis

Actinic keratosis is also called solar or senile keratosis, it is a precancerous skin condition that develops in sun exposed skin, especially on the face, hands, forearms, and the neck. Microscopically, actinic keratoses show varying degrees of microscopic epidermal atypia and abnormal maturation, clinically manifested by keratotic and scaly lesions. Actinic keratoses are mainly due to long-term exposure to the sun in susceptible persons and may progress to squamous cell carcinoma. Actinic keratoses generally measure in size between 2 to 6 millimeters in diameter. They are usually reddish in color and often have a white scale on top. Approximately 50% of Americans over the age of 50 have actinic keratoses. Aks are the potential precursors of squamous cell carcinoma. Actinic keratosis can be the first step in the development of skin cancer, and, therefore, is a precursor of cancer or a precancer. AKs are most likely to appear after age 40, however, in geographic areas with year-round high-intensity sunlight such as Florida and southern California, AKs may be found in persons as young as the teens and twenties. In actinic keratosis, early malignant cells are detected, and because they have not extended through the entire epidermis, they are fairly easy to treat.

Actinic keratosis Causes

The thinning of the ozone layer may be allowing more ultraviolet rays reach the earth. Years of sun exposure cause these cells to change in size, shape, and the way they are organized. Cellular damage can even extend to the dermis, the layer of skin beneath the epidermis.  Actinic keratoses are the most common premalignant lesions. The persons with fair skin, especially those who sunburn easily and tan poorly as well as those whose occupations or hobbies result in excessive sun exposure, are at increased risk of developing actinic keratoses. Actinic keratosis occurs most commonly in fair skin, especially in the elderly and in young individuals with light complexions. So people who have fair skin, blonde or red hair, blue, green, or gray eyes are at the greatest risk. Because their skin has less protective pigment, they are the most susceptible to sunburn. Even those who are darker-skinned can develop keratosis if they heavily expose themselves to the sun without protection. The growths begin as flat, scaly areas that later develop a hard wart-like surface.

Symptoms of Actinic keratosis

Actinic keratoses are small and noticeable red, brown, or skin-colored patches that don't go away. They commonly occur on the head, neck, or hands but can be found on other areas of the body. Usually more than one is present. Skin-colored AKs may be easier to feel than to see and may be noticed more by the touch because they have a sharp, hard scale and feel like sandpaper. They are often sensitive or "touchy." Wrinkling, furrowing, and other signs of sun damage may be present with an AK.  Other symptoms are:

  • Rough and dry textured skin lesion
  • A macule, patch, or growth on the skin
  • Limited to a discrete area (localized)
  • Located on the face, scalp, back of the hands, chest or other sun-exposed areas
  • Color gray, pink, red (erythematous), or the same color as the skin
  • Surface is initially flat and scaly, then becomes slightly raised
  • Surface texture becomes hard and wart-like or gritty, rough, and "sandpapery"; may develop a horn-like texture from overgrowth of skin keratin layer (hyperkeratosis).

Treatment for Actinic keratosis

Because actinic keratoses represent precancerous changes, you should have them examined promptly and follow the health care provider's advice for treatment. Actinic Keratosis may be prevented by protecting skin from ultraviolet radiation. Sun protection is vital for all fair skinned people working or enjoying themselves outdoors. Use a broad spectrum sunscreen on exposed skin every day. Apply sunscreen at least half an hour before exposure, and reapply frequently.

Topical cream is effective in removing keratoses, particularly when lesions are numerous. The patient twice daily applies the medication, with progress checked by a physician. 5-fluorouracil (5-FU) cream, the most commonly used medication, is used for 2 to 4 weeks.

Actinic Keratosis Treatment requires removal of the defective skin cells. New skin then forms from deeper cells which have escaped sun damage. An extremely cold substance, such as liquid nitrogen, is applied to skin lesions. The substance freezes the surface skin, causing blistering or peeling. As your skin heals, the lesions slough off, allowing new skin to appear. Almost all treatments can be performed in the physician's office or in special surgical facilities. Trichloroacetic acid or other caustic agents may provide an alternative way to treat patients with extensive actinic keratoses.

 
 

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