Actinic Keratosis

Li Liu, MD
Last Modified: November 1, 2001

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Question
Dear OncoLink "Ask the Experts,"
Is actinic keratosis a major or minor problem in the USA?

Is there a simple solution to its elimination?

Who can I contact in reference to this?  
Thank you.


Answer
Li Liu, MD, OncoLink Editorial Assistant, responds:

Dear Reader:
Thank you for your interest and question.

Approximately one million new cases of skin cancer will be diagnosed annually in the United States. Among these, 16% are squamous cell carcinoma. The incidence of skin cancer has been going up slowly in the past few years. Please check the website of the American Academy of Dermatology for details.

Actinic keratoses are precancerous lesions of atypical keratinocytes. They appear as red, ill-defined erythematous macules and papules with yellow-brown adherent scales in sun-damaged skin. They are almost always multiple lesions. They are most commonly seen in light-skinned persons in the fourth or fifth decades. Actinic keratoses are important lesions to recognize since approximately 20% to 25% of them eventually transform into carcinoma in situ and finally into invasive squamous cell carcinoma. Any lesion suspected of being a squamous cell cancer should be biopsied. Excision is the treatment of choice. Actinic keratoses are generally treated with cryosurgery, using liquid nitrogen to freeze and destroy the abnormal epidermis or, if numerous, with topical 5-fluorouracil applied as 1 or 5% cream or solution over 2 to 4-week period.

Prevention of actinic keratoses can be achieved by avoiding excessive sun exposure by using protective clothing and sunscreens. You should contact a dermatologist for further information and evaluation of a specific skin lesion.