Actinic Keratosis

WHAT ARE ACTINIC KERATOSIS?

Actinic Keratosis (AKs) are one of the most common skin lesions seen in on sundamaged skin. They are caused by cumulative exposure to ultraviolet radiation. AKs are also referred to by the term "solar keratosis." Actinic Keratosis are some of the most common growths seen at ADAS-Associates in Dermatology and Aesthetic Surgery.

Fig 1. Actinic Keratosis on the hands

Fig 2. Ultraviolet Spectrum

WHY ARE ACTINIC KERATOSIS WORRISOME?

AKs are thought to be, by many, the earliest form of skin cancer. AKs usually begin in the third and fourth decade, and, in six to ten per cent of cases evolve to become an invasive malignancy. Individuals who are fair skinned, have blue eyes or red or blond hair, or are outdoors much of the time are particularly susceptible to Squamous Cell Carcinoma (SCC) development.

WHAT DO ACTINIC KERATOSIS LOOK LIKE?

Actinic keratosis are scaly sandpaper like lesions which can be painful or itchy. They are categorized into four types of lesions:

Fig 3.Actinic Keratosis, pigmented subtype

hypertrophic subtype
pigmented subtype
atrophic subtype
lichenoid subtype

Often, our patients in Jacksonville, Ponte Vedra Beach and Fleming Island note that they "come and go in the same location", are easily palpable, and have some type of discomfort, whether it be itching, tingling or burning.

WHERE DO ACTINIC KERATOSIS FORM AND WHERE ON THE SKIN ARE THEY MOST DANGEROUS?

Actinic Keratosis can form anywhere on the body. They usually form in sun exposed areas such as the face, scalp, and hands. They are most dangerous when they form over the lip or ear regions, as these areas are more susceptible to invasive cancer formation. If you notice recurrent AKs forming on your skin, you should follow-up with us for a skin biopsy.

Fig 4. AKs on lower lip (Actinic Cheilitis)

WHAT ARE SOME OF THE TREATMENTS AVAILABLE FOR ACTINIC KERATOSIS?

We often utilize a liquid nitrogen spray to treat AKs. This causes a slight blistering effect on the skin, and through causing inflammation will rid the skin of the actinic keratosis. For, the lip or ear area (areas of high risk), the best treatment uses Aldara Cream™. This creates a local immune response after 4 weeks of therapy. Two to three treatment sessions are sometimes performed every few months.

Finally, for those patients with a multitude of lesions (where the number of AKs makes either liquid nitrogen a poor choice), 5-fluorouracil cream (Carac™), a common anticancer medication is used. 5FU is applied topically to the skin for two weeks and during this time causes intense inflammation on the skin. Photodynamic therapy or Fraxel re:store laser has also been used to treat these growths.
ARE THERE ANY DIET ISSUES?
Clinical studies suggest that omega-3 fatty acids may be helpful in treating actinic Keratosis lesions. Salvia Hispanica is a grain which is high in this ingredient.

Fig 5. Actinic Keratosis (under the microscope).

SUMMARY

In summary, Actinic Keratosis are thought to be early premalignant skin growths. They can develop into skin cancer in about 6 to 10 % of the time. To schedule an appointment for actinic keratosis treatment or diagnosis, click here or call 904-285-7546.