The risk of progression to invasive disease

Glogau, Richard G.

doi:10.1067/mjd.2000.103339

Cited by 407 publications

(320 citation statements)

References 3 publications

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“…SCC arising from AK rarely metastasizes, with rates between 0.5% and 3% 5 . However, SCC of the lip is more prone to metastasis compared to cutaneous SCC, with rates varying between 3% and 20% [6][7][8] . Furthermore, the risk of metastatic spread to the cervical lymph nodes is higher than that of cutaneous SCC 9 .…”

Section: Discussionmentioning

confidence: 99%

A Case of Metastatic Squamous Cell Carcinoma Arising from Actinic Cheilitis

Kwon

Kim

2011

Ann Dermatol

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Actinic keratosis (AK) is a common, sun-induced, premalignant lesion with a strong likelihood of progressing to a malignancy. The reported risk of AK progressing to squamous cell carcinoma (SCC) varies from less than 1% to 20%. Clinically, induration, pain, large size, marked hyperkeratosis, ulceration, bleeding, rapid growth, and recurrence or persistence may be markers of AK progression into SCC. The risk of SCC metastasizing ranges between 0.5% and 3%. However, SCC of the lip arising from actinic cheilitis is more prone to metastasis than cutaneous SCC, with rates of the former varying between 3% and 20%. Here we report a typical case of SCC from actinic cheilitis with metastasis to the lymph nodes during a 4-year follow-up period. To exclude SCC, we emphasize the need for regular follow-up and prompt evaluation, including careful pathologic examination for actinic cheilitis.

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Section: Discussionmentioning

confidence: 99%

A Case of Metastatic Squamous Cell Carcinoma Arising from Actinic Cheilitis

Kwon

Kim

2011

Ann Dermatol

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“…Here, we review the clinical data on BF-200 ALA for AK along with a summary of molecular mechanisms and future perspectives. Actinic keratosis (AK), also known as solar keratosis, is caused by chronic exposure to sunlight or other ultraviolet light sources [1,2] and may progress to invasive squamous cell carcinoma (SCC) [3]. It is the most common lesion with malignant potential to arise on the skin.…”

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confidence: 99%

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Reinhold¹

2017

Future Oncol.

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BF-200 ALA is a combination of a nanoscale-lipid vesicle formulation and the prodrug 5-aminolevulinic acid (5-ALA). The nanoemulsion stabilizes the prodrug and enhances its penetration through the stratum corneum. It has shown excellent therapeutic results in both lesion and field-directed photodynamic therapy of actinic keratosis (AK). AK is an early form of epidermal neoplasia and a precursor of invasive cutaneous squamous cell carcinoma. It is characterized by the combination of visible neoplastic lesions and surrounding tissue also harboring tumorigenic UV-induced mutations: a concept called field cancerization. A selective, field-directed treatment is ideal to meet the requirements of field change. Here, we review the clinical data on BF-200 ALA for AK along with a summary of molecular mechanisms and future perspectives. Actinic keratosis (AK), also known as solar keratosis, is caused by chronic exposure to sunlight or other ultraviolet light sources [1,2] and may progress to invasive squamous cell carcinoma (SCC) [3]. It is the most common lesion with malignant potential to arise on the skin. AK is mostly seen in Caucasians in skin areas that have extensive sun exposure throughout their lives [4]. Epidemiological data show a high occurrence rate of AK. Regions with higher ultraviolet exposure have a higher prevalence of AK. For the USA, the prevalence was estimated to range from 11 to 26%, while in Australia it ranged from 40 to 60%. In Europe, a prevalence of 15% in men and 6% in women has been documented [5]. Over the age of 70 years, 34% of men and 18% of women were found to have actinic keratotic lesions [6]. Next to fair skin type, an advanced age and lifelong sun exposure immunosuppression/-deficiency plays another important risk factor [5].Mostly, AK develops slowly and early in the disease process, they may disappear only to reappear later. Recurrence of the disease may include partial elimination of the initial lesion, subclinical lesion progression to visible status, or development of new lesions [7]. On top of this, an AK may progress to invasive SCC, the second-most common form of skin cancer [8,9]. The actual percentage of progress to invasive SCC remains unknown, and estimates vary from 5 to 20% within 10 to 25 years with reported annual transformation rates varying greatly from as low as 0.25% to as high as 16% [10]. The regression rate for a single untreated lesion is 15 to 63% after a year; recurrence rates range from 15 to 53% [11]. In general patients develop multiple AKs in one area and predicting which course each individual lesion will follow is impossible. Nonetheless, AK lesions are reliable markers for patients who are most predisposed to developing invasive SCC [4,[12][13].AK lesions typically appear in areas most frequently exposed to the sun such as the face, back of the hands, or bald scalp; 75% of lesions are found on the head, neck and forearms [14]. The lesions vary in appearance as well as size and can include erythematous scaly macules, rough pigmented patches and hyperker...

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“…In fact, it is unknown which proportion of actinic keratoses progress to squamous cell carcinomas. It has been stated that the likelihood of a squamous cell carcinoma developing from a given actinic keratoses is around the rate of 0.1 per year (24).…”

Section: Discussionmentioning

confidence: 99%

Epidermal field carcinogenesis in bald-headed: An attempt at finetuning early non-invasive detection

et al. 2009

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Abstract. Skin weathering and photoaging of the balding scalp have not attracted much investigative attention so far. However, the concept of field cancerization, in particular actinic field carcinogenesis, is likely applicable to this part of the body. The aim of the study was to finetune the epidermal actinic changes present on hairlessness scalp. The ultraviolet light-enhanced visualization (ULEV) method was used to assess a series of 50 healthy men older than 50 years with documented baldness for over 15 years. They were scrutenized looking for altered epidermal structures corresponding to photoaging-associated changes. Attention was focused on the faint mosaic melanoderma (FMM) and atypical scaliness. Observations were made on the scalp and forehead. FMM was recognized in each case. It presented either as a single manifestation of photoaging or it was associated with an unusual pattern of discrete rimmed scaliness. In this latter case histology and morphometry disclosed keratinocyte dysplasia. A similar scaly pattern was not seen on the forehead. Subtle skin surface changes were disclosed on long-standing sun-exposed balding scalps. The scaly aspect was distinct from dandruff, seborrheic dermatitis or any other common inflammatory scalp dermatosis. The presently described changes had not previously been described during early balding. It is suggested that the presently described condition may be associated with or indicative for actinic field carcinogenesis and incipient keratinocyte dysplasia.

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The risk of progression to invasive disease

Cited by 407 publications

References 3 publications

A Case of Metastatic Squamous Cell Carcinoma Arising from Actinic Cheilitis

A Case of Metastatic Squamous Cell Carcinoma Arising from Actinic Cheilitis

A review of BF-200 ALA for the photodynamic treatment of mild-to-moderate actinic keratosis

Epidermal field carcinogenesis in bald-headed: An attempt at finetuning early non-invasive detection

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