Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects

Abstract

Actinic keratoses are dysplastic proliferations of keratinocytes with potential for malignant transformation. Clinically, actinic keratoses present as macules, papules, or hyperkeratotic plaques with an erythematous background that occur on photoexposed areas. At initial stages, they may be better identified by palpation rather than by visual inspection. They may also be pigmented and show variable degrees of infiltration; when multiple they then constitute the so-called field cancerization. Their prevalence ranges from 11% to 60% in Caucasian individuals above 40 years. Ultraviolet radiation is the main factor involved in pathogenesis, but individual factors also play a role in the predisposing to lesions appearance. Diagnosis of lesions is based on clinical and dermoscopic examination, but in some situations histopathological analysis may be necessary. The risk of transformation into squamous cell carcinoma is the major concern regarding actinic keratoses. Therapeutic modalities for actinic keratoses include topical medications, and ablative and surgical methods; the best treatment option should always be individualized according to the patient.

Ingol and Ingenol-Type Diterpenes from Euphorbia trigona Miller with Keratinocyte Inhibitory Activity

“…The main risk factor of induction of AK is UV irradiation. The UVB component of sunlight damages DNA, which might cause mutations in p53 and other tumor suppressor genes [25]. Therefore, as an in vitro model of AK, we used the HPV-Ker cell line which contains the E6 oncoprotein of the human papillomavirus, leading to the degradation of the p53 tumor suppressor [26].…”

Analysis of dermatologic conditions in Turkey and Italy by using Google Trends analysis in the era of the COVID ‐19 pandemic

“…31 It is well known that older adults are in a high-risk group for many types of skin cancer. 32 Thus, the restrictions policies in order to deal with COVID-19 may have decreased the number of patients who request dermatology outpatient clinic visits for skin cancer hereby "skin cancer" search term in Google Trends. Similarly, "sunscreen" search term can also be considered in this regard.…”

Aktinische Keratosen

“…Ein höheres Risiko besteht auch bei Patienten unter immunsuppressiver Therapie, z. B. nach Organtransplantation, sowie bei Patienten mit Albinismus oder jenen die unter der seltenen Genodermatose Xeroderma pigmentosum leiden, bei der eine Störung der DNA-Reparatur zugrunde liegt [14]. Studien aus Australien zeigen allerdings, dass sich etwa 25 % der AKs spontan zurückbilden [15].…”

“…Early squamous cell carcinoma of the skin • Field cancerization • Atypical keratinocytes • Immunosuppression • Precancerous conditions lichkeit oder Entzündungszeichen [14]. Problematisch an der Olsen-Klassifikation ist, dass die klinische Einteilung und die Dicke der Hyperkeratose nicht mit der histologischen Differenzierung korrelieren [28].…”