In France, actinic keratosis is one of the most common reasons for consultation in dermatology . This dermatosis is often observed in people over the age of 60 and more often affects fair skin .
Actinic keratosis can be a precancerous skin lesion and should therefore be examined, evaluated and monitored by a medical specialist . Not all actinic keratoses turn into skin cancer.
Overexposure to the sun is the main cause of actinic keratosis, hence its name “ solar keratosis ”.
At Skin Marceau , solar keratosis is treated with co2 laser.
Actinic keratosis is caused by chronic exposure to the sun. Ultraviolet ( UV) rays from the sun cause excessive growth of keratinocytes, the cells in the top layer of the skin. This can lead to the formation of keratotic lesions .
Unlike seborrheic keratosis, actinic keratosis poses a skin cancer risk . This is one of the reasons why it is recommended to see your dermatologist once a year.
People with light phototypes are more likely to develop actinic keratoses than people with dark skin. Indeed, these individuals are more sensitive to the harmful effects of the sun and to the appearance of keratotic lesions. Occupational exposure as well as artificial tanning are also likely to cause senile keratosis .
If caught early, actinic keratoses can be treated before they possibly develop into skin cancer . Even if the risk of progression to cutaneous squamous cell carcinoma is low (5 to 15% of cases of actinic keratosis), the biopsy is systematic.
The areas affected by actinic keratosis are the face, neck, hands, arms, lower limbs and scalp of patients with baldness.
On examination, one generally finds plaques of different colors (red, beige, flesh color or even brown) and of very small size, crusty in appearance, palpable and rough to the touch: they are often found by the skin. palpation and are almost invisible to the naked eye. The multiple nature of the lesions is more frequently observed. Around the lesion, signs of photoaging such as brown spots or redness may be present.
Actinic keratosis should be monitored: any change in appearance such as inflammation or induration, bleeding , rapid increase in size, pain should prompt a prompt consultation.
One of the forms of actinic keratosis is actinic cheilitis , it manifests itself at the level of the lower lip .
Clinical examination is most often sufficient to establish the diagnosis of actinic keratosis. The use of dermatoscopy helps to eliminate aspects
A skin biopsy may be indicated for atypical lesions.
Be careful to differentiate between seborrheic keratosis and actinic keratosis. Seborrheic keratosis (or seborrheic wart ) is a perfectly benign lesion, non-contagious and can be itchy. Its shape is reminiscent of that of the wart , brown in color and with a scaly or warty surface. In this case, the treatment is requested for a purely aesthetic reason.
Since they can transform into squamous cell carcinoma at any time, actinic keratosis lesions must be treated. Photoprotection remains an essential part of the treatment .
First of all, we emphasize the importance of sun protection in patients with actinic keratoses. Indeed, the presence of these lesions is synonymous with depletion of the sun’s capital : it is therefore essential to adopt physical protection (clothing, hats, etc.) as well as the application of suitable sunscreens.
The treatment of choice for actinic keratoses is the co2 laser . This technology allows direct vaporization of the target lesion with rapid and optimal healing. Other techniques are possible but are less recommended: these are cryotherapy via liquid nitrogen. This method relies on cold to destroy keratotic lesions and is likely to leave depigmented scars .
The creams in the treatment of actinic keratoses are based on 5-Fluorouracil (5FU), Imiquimod or even diclofenac: they can have undesirable effects depending on the patient.
In case of diagnostic doubt, surgical excision followed by a skin biopsy is indicated.