Actinic keratosis is also called solar keratosis. This term is more specific, as it indicates that the disease is caused by sunlight. But in general, actinic keratosis can be caused by any rays, including in solariums. Some researchers consider actinic keratosis a precancerous condition, others consider it malignant and insist on immediate removal. It is very important to diagnose this disease in time and correctly and prevent the development of dangerous consequences.
Actinic Keratosis – This is a limited skin neoplasm that occurs primarily in fair-skinned people. It takes the form of horny papules and develops on skin surfaces exposed to the sun.
Some researchers consider actinic keratosis to be a pre-malignant lesion, others believe it should be considered superficial squamous cell carcinoma, others insist that it is an indefinitely long-term condition that may or may not become malignant.
Causes of the development of actinic keratosis and the nature of the manifestation
Actinic keratosis develops in people with skin phenotype I-III who have received too much sun exposure at once (acute keratosis) or throughout their life (chronic keratosis). Chronic actinic keratosis often affects people who, due to professional activities, receive constant exposure to sunlight on the skin (sailors, drivers, farmers) or live in areas with a large number of sunny days. light, the excess of which is easy to get, being carried away by the solarium.
Clinical characteristics of actinic keratosis
Under the influence of sunlight, the skin becomes dry and hyperpigmented, and many small (1-2 mm) rough lesions appear on it, slightly raised above the skin surface and having uneven edges. Lesions are flesh-colored or pink, erymatous, with telangiectasias, their surface is covered with yellow or brown scales adjacent to the skin. If the scales are removed, painful small erosions form and slightly keratinized proliferations open inside the follicular pores.
Typical localization of foci of actinic keratosis – this is the forehead, nose, cheeks and ears, the surface of the head in balding men, the back of the hand, the forearm. On the head and neck, lesions are usually thin, and on the palms and forearms – denser. As the disease progresses, a hard, horny proliferation known as verrucous keratosis increases.
Hardware and drug treatment of actinic keratosis
The diagnosis of actinic keratosis is usually straightforward and based on the clinical presentation, although a biopsy is sometimes needed.
The treatment of actinic keratosis consists in its removal by the method determined by the dermatologist based on the examination, history and location of the tumor.
Therapy of choice in the treatment of actinic keratosis today is laser skin resurfacing, which gives good results. In some cases, cryosurgery, dermabrasion are used to remove foci of actinic keratosis; if necessary, surgical extirpation is used to remove a dense horny papule.
Among the methods of drug treatment of multiple actinic keratosis, median chemical peeling with trichloroacetic acid has proven itself well. The combination of low doses of systemic isotretinoin and topical 5-fluorouracil dramatically reduces the number of actinic keratosis foci and prevents new growths. Intralesional administration of interferon makes it possible to clear more than 90% of actinic keratosis foci.
Patients should be aware of the need for sun protection to avoid the risk of immunosuppression. Before going out in the sun, apply a broad-spectrum sunscreen with an SPF of at least 30 to all parts of the body, wear tight clothing and hats, and avoid being outdoors during the active sun.
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