Causative & risk factors
Actinic keratosis is caused by long-term exposure to the sun’s ultraviolet rays. Hence people who work outdoors have a higher risk of developing this condition. The number of lesions increases with age. People with lighter skin, blonde hair or colored eyes (blue, green) have a higher risk of developing actinic keratosis. Those with an underlying skin disorder such as xeroderma pigmentosum or albinism are also more prone to develop actinic keratosis.
People suffering from immunodeficiency diseases like AIDS or those under treatment with immunosuppressive drugs or chemotherapy have a higher risk of developing actinic keratosis. Some antibiotics like tetracycline also increase the risk of developing actinic keratosis.
Clinical presentation
Actinic keratosis presents as dry, rough lesions on the skin on face, scalp, back of the hands, chest, or other sun-exposed areas of grey, pink, red color of similar to skin color. Lesions begin as flat and scaly areas and then form hard, rough, gritty, horn-like or sandpapery surface. It is easier to feel the lesion rather than seeing them due to their abnormal, scaly or rough consistency. The lesions are not permanent; they can frequently appear or disappear. Sometimes horny growths may develop.
Investigations
Visual examination is sufficient to diagnose actinic keratosis in most of the cases. A biopsy is done to confirm or eliminate the possibility of squamous cell carcinoma.
Treatment
Topical medicated creams are prescribed to be applied on the lesions.
Photodynamic therapy – The lesions are covered with a photodynamic agent, i.e. an agent which will make your skin more sensitive to light. Laser therapy is then used to destroy the lesions.
Freezing the lesions (cryotherapy) or scraping them off (curettage) are other treatment options.
In order to prevent the onset of actinic keratosis, one must limit sun exposure and use sunscreens regularly. Any changes in the skin must be checked by a physician.
Recent updates
Several new topical ointments are being tested for their efficacy in treating actinic keratosis.
