Actinic keratoses

Actinic keratoses

    * Introduction
    * Pathogenesis and causes
    * Signs and symptoms
    * Diagnosis
    * Treatment
Actinic keratosis is a UV-induced skin lesion that may progress to squamous cell carcinoma. It is by far the most common potentially malignant lesion of the skin. Actinic keratosis is seen in people with thin skin areas that were long-term sun exposure.
Nature premalignant actinic keratosis was recognizing 100 years ago and the name literally means increased thickening of the skin (keratosis) caused by the sun (actinic). An actinic keratosis can follow three ways: it can regress, persist unchanged or may progress to invasive squamous cell carcinoma. The current percentage that progresses to squamous cell carcinoma remains unknown but is estimated to be between 0. 1 and 10%. Recent data suggest that actinic keratosis may progress to basal cell carcinoma.
Actinic keratoses prognosis is good. Actinic keratosis occurs most often in white, the frequency correlates with sun exposure. More frequency increases with age, proximity to the equator and occupations in the open environment. Actinic keratosis is seen more in men than in women and correlate with a high fat diet.
Injuries debuts as barely perceptible rough spots on the skin, better felt than seen. Early lesions that are felt on palpation rasspapirul, later become erythematous, thick plates that can range from a few cm. The lesions may remain unchanged for years, can regress spontaneously or may progress to invasive squamous cell carcinoma. Most actinic keratoses do not progress to carcinoma, however, invasive squamous carcinomas most drifting out of a pre-existing actinic keratosis. Invasive squamous cell carcinoma can cause significant morbidity in facial structures by direct extension. In less than 10% of squamous cell carcinoma can metastasize cases with a 5-year survival rate low.
Appropriate treatment is generally chosen based on the number of lesions present and efficacy. Treatment consists of two broad categories: pharmacologic therapy and surgical destruction. The patient must be educated to limit sun exposure. Also must use appropriate protective creams and clothing. Approved medical therapy administered four agents: 5-fluorouracil, imiquimod, diclofenac acid gel and delta-animolevulinic PDT.
The aim of surgical therapy is to completely eradicate actinic keratoses by physical destruction without damaging adjacent tissue. When the diagnosis is uncertain and the possible presence of a tumor is invasive biopsy is indicated. The biopsy usually leaves a scar. Use Cryosurgery, curettage, or conventional tangential excision and facial cosmetic procedures in the entire epidermis is removed. Actinic keratoses prognosis is good. With continuous monitoring and treatment of these injuries can be controlled. The opportunity to become malignant can be prevented by aggressive therapy and sun protection. However, the prognosis for someone with long-term exposure is more reserved because of the multitude of injuries. Some lesions may progress and develop carcinomas. Patients with extensive disease unresponsive to cryosurgery and topical therapy may benefit from dermoabraziune, chemical peels and laser therapy.