3.3.1 Actinic Keratosis
Grading & Level of Importance: B
Dependent of skin type and life conditions. Prevalence in UK 6% in female and 15% in male.
Carcinoma in situ caused by chronic UV light exposure.
Aetiology & Pathogenesis
Chronic UV exposure followed by mutations of keratinocytes. In addition human papilloma virus (HPV), chemicals, genetic predisposition, immunosuppression.
Signs & Symptoms
Circumscribed hyperkeratotic yellow-brownish papules or plaques, sometimes flat or atrophic
Sun-exposed areas (scalp, face, back of hands, shins, forearms).
Grade 1 to 3
Laboratory & other workups
Hyperkeratosis, epidermal disarray, atypical keratinocytes, inflammatory infiltrate, actinic elastosis.
Chronic over years.
Transition to squamous cell carcinoma possible.
Clinical features, histology.
Prevention & Therapy
Prevention: sun protection.
Treatment: physical methods (cryosurgery, curettage, photodynamic therapy), topical methods (5-fluorouracil or immune modifiers: imiquimod cream, diclofenac, ingenol mebutate).
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