Actinic keratoses are one of the most commonly encountered skin conditions that dermatologists see. Actinic keratoses are a result of cumulative sun exposure. These tend to present as tender, red scaly growths that present on chronically sun exposed sites. They are often rough, elevated, and can be occasionally confused as warts. The common description, is that these spots will flake off, and eventually come right back in the same location.
If left untreated, these do have the potential, up to ten percent of the time, to turn into squamous cell carcinoma, a type of skin cancer. These have a higher chance to turn into a squamous cell carcinoma if located on the lips and ears. Since these are considered premalignant, we do recommend that these are treated.
The three main types of treatment for these are cryosurgery, photodynamic therapy, and topical chemotherapeutics. For additional information regarding each of these types of treatment option, please click on the link that will discuss these treatment options in depth. For additional information on actinic keratoses, please see SkinCancer.org. Photodynamic therapy is becoming an increasing popular treatment modality for its relatively quicker treatment time, and its efficacy for larger areas of actinic damage. The Cleaver Medical Group is able to offer this advanced treatment for their patients. For more information regarding photodynamic therapy, please see the National Institute of Health‘s website discussing this effective treatment.
Actinic keratoses may remain unchanged, spontaneously resolve, or progress to invasive squamous cell carcinoma. The fate of any one actinic keratosis is impossible to predict. The appropriate treatment is generally chosen based on the number of lesions present and the efficacy of the treatment. Additional variables to consider include persistence of the lesion, age of the patient, history of skin cancer, and tolerability of the treatment modality. Treatment consists of 2 broad categories: surgical destruction of the lesion and medical therapy. Medical therapy has the advantage of being able to treat large areas with many lesions. Actinic keratoses are common intra-epidermal neoplasms that lie on a continuum with squamous cell carcinoma. Tightly linked to ultraviolet irradiation, they occur in areas of chronic sun exposure, and early treatment of these lesions may prevent their progression to invasive disease. A large variety of effective treatment modalities exist, and the optimal therapeutic choice is dependent on a variety of patient and physician-associated variables.