What are actinic keratoses?
Actinic keratoses are lesions that appear on skin exposed mainly to ultraviolet rays.
that are very frequent, that can appear in 30 to 40% of people, more so in those who have been exposed to ultraviolet rays.
people, more in those who have been exposed to ultraviolet rays, more in those who have fair skin.
Are they frequent?
Actinic keratoses are a very common pathology that has been increasing in frequency in recent years.
frequency in recent years. This is mainly due to the recreational and lifestyle habits we have in the western world, to a greater exposure to the sun. They occur in up to 25% of people in our environment, and in countries like Australia where there is greater sun exposure and have a lighter skin type, the figures can reach up to 50 or 70% of the population.
What are the causes and how are they diagnosed?
The fundamental cause of the appearance of actinic keratoses is exposure to ultraviolet radiation, VA and VB rays. Another factor that is responsible for the appearance are genetic factors, skin type. Light phototypes are more prone to develop actinic keratoses. And a third important factor is immunosuppression, in people with organ transplants receiving immunosuppressive treatments actinic keratoses are more frequent. The diagnosis of actinic keratoses is fundamentally clinical, the appearance of the lesions. They are scaly lesions, on a reddish base, adherent, sometimes forming cutaneous horns. They appear mainly on the face, scalp, back of the hands and décolleté. In areas that are regularly exposed to ultraviolet radiation, we have two techniques, dermoscopy and focal microscopy that help us to increase sensitivity and diagnostic accuracy, and to differentiate them from other lesions that may simulate actinic keratosis. In doubtful cases we require biopsy to confirm the diagnosis.
What treatments are available and what is the value of photodynamic therapy?
We have multiple treatments for actinic keratosis. It will depend on whether they are single lesions, whether they are multiple lesions, where they are located, the age of the patient and whether there are other factors such as immunosuppression for us to choose one or another treatment. We have cryotherapy, widely used by dermatologists as a treatment for single lesions. We have different treatments that we call field treatments, which treat the entire area where the actinic keratosis is and where new actinic keratoses may appear. Here there has been a revolution and great research in recent years with the appearance of multiple products with high efficacy and high safety. And we also have photodynamic therapy and laser for the treatment of these skin alterations. Photodynamic therapy consists of the application of a topical product, a cream, on the skin and subsequent irradiation with a specific light. This sensitizes and activates the chemical product in such a way that it selectively destroys the actinic keratosis cells, the precancerous cells, preserving normal skin. It is a highly effective procedure in the treatment of actinic keratoses that has proven to be safe and at the same time achieves very satisfactory cosmetic results.