Epidemiology of solar keratoses

Abstract

SUMMARY Solar keratoses (SKs) or actinic keratoses are common dysplastic epidermal lesions which occur in pale‐skinned individuals who are chronically exposed to intense sunlight. Together with basal cell carcinomas and sqamous cell carcinomas, they constitute a major public health problem in such individuals. Reported SK prevalence rates range from 11 to 25% in various northern hemisphere populations, and amongst Australian adults the range is from 40 to 60%. In the only study to date reporting SK incidence data, 60% of subjects aged 40 years and over with SKs at baseline developed new lesions during 12 months of follow‐up, compared with only 19% of those who were lesion‐free on the first examination. Because existing epidemiological data on SKs are sparse, very little is known of their natural history, their role in carcinogenesis, or their preventability. In this review, current knowledge about the aetiology, diagnosis, and occurrence of SKs is discussed, as is the need for prospective studies in unselected communities. With accurate baseline data, public health authorities should be in a better position to determine the best preventive strategies, and to evaluate the effectiveness of these programmes.

Human papillomavirus type spectrum in normal skin of individuals with or without a history of frequent sun exposure

“…It has been reported that more HPV types have been found in actinic keratosis and SCC skin lesions than in normal skin (Alotaibi et al, 2006), and a greater variety of HPV types have also been found in immunosuppressed individuals than in immunocompetent individuals (Harwood et al, 2004). Both SCC and BCC develop mostly on sun-exposed sites (Frost & Green, 1994), and some specific types of HPV, including HPV-5, HPV-8, HPV-20 and HPV-77, have been shown to be activated by UV radiation (Akgül et al, 2005;Massimi et al, 2008;Michel et al, 2006;Purdie et al, 1999;Storey et al, 1998). Evidence of UV-induced E6/E7 oncogenicity and transcriptional activity of E6/E7 oncogenes in NMSC has been found (Al Moustafa et al, 2004;Dang et al, 2006;Michel et al, 2006).…”

Measurements of the anatomical distribution of erythemal ultraviolet: a study comparing exposure distribution to the site incidence of solar keratoses, basal cell carcinoma and squamous cell carcinoma

“…Like NMSC, actinic or solar keratoses (SK) are also commonly observed in fair skinned populations that are exposed to high ambient levels of UV radiation such as those which occur in Australia 8,9 . These cutaneous legions have been noted to be more prevalent on sun exposed regions of the body compared to BCC and SCC leading to SK being noted as potentially better markers of sunlight exposure than the presence of skin cancers 8 .…”

Oral acetylsalicylic acid and prevalence of actinic keratosis

“…In Australia, it is estimated that 40-50% of the population above 40 years of age presents at least one lesion. 6,7 Considering that AKs can be models of in-vivo studies of skin carcinogenesis, the identification of factors that can prevent AKs may reveal potential preventive or therapeutic measures related to skin cancer, especially squamous cell carcinoma (SCC). 8 For decades, the role of non-steroidal anti-inflammatory drugs (NSAI) and mainly acetylsalicylic acid (ASA) has been studied in an attempt to prevent some types of cancer, especially colon and skin cancers.…”