Actinic keratoses are clinically important because they have the potential to develop into squamous cell carcinomas. Treatment is aimed at preventing this transformation and at symptomatic and cosmetic improvement.
- Actinic keratoses (AKs) are extremely common – about 60% of Caucasians in Australia will have at least one by the age of 40 years.
- They are localised proliferations of aberrant keratinocytes that develop most often from prolonged exposure to UV radiation but also as a result of immunosuppression, human papillomavirus infection and arsenic exposure.
- AKs may develop into squamous cell carcinomas (SCCs), and therefore are strong predictors of the subsequent development of nonmelanoma skin cancers.
- If thickening, bleeding or tenderness are present in an AK, malignancy should be excluded before treatment is commenced.
- Patients at high risk of SCC should have their AKs biopsied if there is any doubt about the diagnosis.
- The most commonly used management options for removal are cryotherapy and 5-fluorouracil cream.