Actinic keratoses, commonly known as senile keratoses or sun keratoses, are benign intraepithelial neoplasms and one of the most prevalent skin conditions examined by dermatologists.
AKs are frequently connected with prolonged sun exposure and may manifest as irregular, red, scaly papules or plaques on sun-exposed areas of the body.
AKs have the potential to develop into invasive SCC if left untreated, highlighting the significance of early identification and the establishment of a treatment plan. Several management strategies are available for AKs.
Epidemiology
Actinic keratoses are most prevalent on persistently sun-exposed regions on the body. Older individuals have a higher risk of developing these due to the longer accumulated exposure to the sun.
Regions which are more susceptible to developing actinic keratoses include the scalp, face, dorsal surface of the hands, and the back of the arms.
Risk factors which are linked to actinic keratoses are:
Male Sex
Older age
Caucasians or fair individuals
Immunosuppression
Geographic location- areas closer to the equator
History of skin cancer or actinic keratosis
Chronic sun exposure
Individuals exposed to artificial sources of UV rays
Individuals with conditions such as xeroderma pigmentosum and albinism
Anatomy
Pathophysiology
The pathophysiology underlying the development of actinic keratoses is complicated. Through the breakdown of regulatory mechanisms involved in cell development and differentiation, excessive and accumulative UV radiation exposure can produce a multitude of pathologic alterations in epidermal keratinocytes. Inflammation and immunosuppression leads to the growth of dysplastic keratinocytes within the epidermis, which gives birth to actinic keratosis.
Etiology
Most cases of actinic keratoses develop due to the damage caused to skin because of UV radiation through chronic sun exposure.
Genetics
Prognostic Factors
Most cases of actinic keratoses regress spontaneously, due to some mechanism not completely understood. Other cases have a risk of evolving into squamous cell carcinoma.
Actinic keratoses is the most comma risk factor for squamous cell carcinoma, as most cases develop from former AKs or between a region affected by actinic keratoses. For a favorable outcome, patients are advised regular skin exams to spot new AKs and diagnose SCC in the early stages.
Extremities or Trunk: Apply 0.05% of gel to the affected area every day for two days.
Scalp or Face: Apply 0.015% of gel to the affected area daily for three days; avoid applying the gel in or close to the eyes, the mouth, or the lips.
Applying gel in more than one area at once is not advised.
should be applied to one contiguous skin area that is no more than 25 cm² (5×5)
Not to be used as a spot therapy for actinic keratosis upon more than 25 cm2 of areas simultaneously.
Apply illumination to specific areas, possibly for therapeutic purposes
The treatment session lasts for 8 weeks
If the treated lesions have not entirely resolved after the initial 8-week treatment session, a second treatment may be administered
Apply the topical cream on the lesion using gauze prepared by a curette
Apply a thin layer of 1 mm thickness
Do not keep more than 1 gm of cream on the skin
Let the cream on the skin for 2.5-4 hours only
Apply topically onto affected area one time in a day until lesions are cleared
Minimum 10 lesions at a time may be treated Dosing modification Renal impairment
Not suggested
Hepatic impairment
Dose modification not required
Actinic keratoses, commonly known as senile keratoses or sun keratoses, are benign intraepithelial neoplasms and one of the most prevalent skin conditions examined by dermatologists.
AKs are frequently connected with prolonged sun exposure and may manifest as irregular, red, scaly papules or plaques on sun-exposed areas of the body.
AKs have the potential to develop into invasive SCC if left untreated, highlighting the significance of early identification and the establishment of a treatment plan. Several management strategies are available for AKs.
Actinic keratoses are most prevalent on persistently sun-exposed regions on the body. Older individuals have a higher risk of developing these due to the longer accumulated exposure to the sun.
Regions which are more susceptible to developing actinic keratoses include the scalp, face, dorsal surface of the hands, and the back of the arms.
Risk factors which are linked to actinic keratoses are:
Male Sex
Older age
Caucasians or fair individuals
Immunosuppression
Geographic location- areas closer to the equator
History of skin cancer or actinic keratosis
Chronic sun exposure
Individuals exposed to artificial sources of UV rays
Individuals with conditions such as xeroderma pigmentosum and albinism
The pathophysiology underlying the development of actinic keratoses is complicated. Through the breakdown of regulatory mechanisms involved in cell development and differentiation, excessive and accumulative UV radiation exposure can produce a multitude of pathologic alterations in epidermal keratinocytes. Inflammation and immunosuppression leads to the growth of dysplastic keratinocytes within the epidermis, which gives birth to actinic keratosis.
Most cases of actinic keratoses develop due to the damage caused to skin because of UV radiation through chronic sun exposure.
Most cases of actinic keratoses regress spontaneously, due to some mechanism not completely understood. Other cases have a risk of evolving into squamous cell carcinoma.
Actinic keratoses is the most comma risk factor for squamous cell carcinoma, as most cases develop from former AKs or between a region affected by actinic keratoses. For a favorable outcome, patients are advised regular skin exams to spot new AKs and diagnose SCC in the early stages.
Extremities or Trunk: Apply 0.05% of gel to the affected area every day for two days.
Scalp or Face: Apply 0.015% of gel to the affected area daily for three days; avoid applying the gel in or close to the eyes, the mouth, or the lips.
Applying gel in more than one area at once is not advised.
should be applied to one contiguous skin area that is no more than 25 cm² (5×5)
Not to be used as a spot therapy for actinic keratosis upon more than 25 cm2 of areas simultaneously.
Apply illumination to specific areas, possibly for therapeutic purposes
The treatment session lasts for 8 weeks
If the treated lesions have not entirely resolved after the initial 8-week treatment session, a second treatment may be administered
Apply the topical cream on the lesion using gauze prepared by a curette
Apply a thin layer of 1 mm thickness
Do not keep more than 1 gm of cream on the skin
Let the cream on the skin for 2.5-4 hours only
Apply topically onto affected area one time in a day until lesions are cleared
Minimum 10 lesions at a time may be treated Dosing modification Renal impairment
Not suggested
Hepatic impairment
Dose modification not required
Actinic keratoses, commonly known as senile keratoses or sun keratoses, are benign intraepithelial neoplasms and one of the most prevalent skin conditions examined by dermatologists.
AKs are frequently connected with prolonged sun exposure and may manifest as irregular, red, scaly papules or plaques on sun-exposed areas of the body.
AKs have the potential to develop into invasive SCC if left untreated, highlighting the significance of early identification and the establishment of a treatment plan. Several management strategies are available for AKs.
Actinic keratoses are most prevalent on persistently sun-exposed regions on the body. Older individuals have a higher risk of developing these due to the longer accumulated exposure to the sun.
Regions which are more susceptible to developing actinic keratoses include the scalp, face, dorsal surface of the hands, and the back of the arms.
Risk factors which are linked to actinic keratoses are:
Male Sex
Older age
Caucasians or fair individuals
Immunosuppression
Geographic location- areas closer to the equator
History of skin cancer or actinic keratosis
Chronic sun exposure
Individuals exposed to artificial sources of UV rays
Individuals with conditions such as xeroderma pigmentosum and albinism
The pathophysiology underlying the development of actinic keratoses is complicated. Through the breakdown of regulatory mechanisms involved in cell development and differentiation, excessive and accumulative UV radiation exposure can produce a multitude of pathologic alterations in epidermal keratinocytes. Inflammation and immunosuppression leads to the growth of dysplastic keratinocytes within the epidermis, which gives birth to actinic keratosis.
Most cases of actinic keratoses develop due to the damage caused to skin because of UV radiation through chronic sun exposure.
Most cases of actinic keratoses regress spontaneously, due to some mechanism not completely understood. Other cases have a risk of evolving into squamous cell carcinoma.
Actinic keratoses is the most comma risk factor for squamous cell carcinoma, as most cases develop from former AKs or between a region affected by actinic keratoses. For a favorable outcome, patients are advised regular skin exams to spot new AKs and diagnose SCC in the early stages.
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