Strange Actinic Keratosis Symptoms - Solar Keratosis

Solar Keratosis

Actinic keratosis or solar keratosis is considered premalignant and may develop into squamous cell carcinoma if left untreated. It was first described in 1806 by Sir Thomas Browne as "squamous cell papilloma." However, it was not until 1963 that the term actinic keratosis was proposed and named because it resembles solar keratosis, a lesion caused by prolonged exposure to sunlight.

Actinic keratosis (AK) is a skin lesion commonly found in areas of the body chronically exposed to sunlight, such as the back of hands and face. AKs are ubiquitous and represent about 90% of pre-cancerous lesions in fair skin types. However, they are rare in dark-skinned individuals because most lesions occur on the face and hands, where there is less pigment than in other areas.

The most common solar keratosis type is senile keratosis (SK), representing about 50% of all actinic keratosis.

Actinic Keratoses Risk Factors

Among actinic keratosis risk factors, there are:

• Fair skin type.
• Older than 60 years of age.
• Outdoor occupation or recreational activities during the day.

People at increased risk for actinic keratoses are those with lighter skin types, particularly if they are older than 60 years of age. This means it is more frequent in Caucasians, particularly those with red hair and green eyes. This suggests that the risk of actinic keratosis is increased fourfold for those with skin type 1 compared to skin type 7.

Also, it is more common in men, most likely due to outdoor occupations or recreational activities.

Finally, it is more prevalent in people who are older than 60 years of age, probably due to decreased protective melanin production with aging.

Severe actinic damage occurs when the skin does not receive the daily doses of sun that are required to suppress actinic keratosis formation.

Types of Keratosis

There are three main types of keratosis:

• Actinic keratosis is the most common type of keratosis, caused by damage to the skin from ultraviolet (UV) radiation. UV radiation is a type of energy that comes from the sun, tanning beds, and other sources. UV radiation can damage the DNA in your skin cells. This damage can lead to changes in the cells that can cause them to become cancerous.
• Basal cell carcinoma is the most common type of skin cancer. It usually forms on areas of the body that get a lot of sun exposure, such as the head, neck, and shoulders. Basal cell carcinomas typically look like small, round, or oval growths on the skin. They can be red, white, tan, or black.
• Squamous cell carcinoma is the second most common type of skin cancer. It usually forms on areas of the body that get a lot of sun exposure, such as the head, neck, and shoulders. Squamous cell carcinomas can also develop inside the mouth, genitals, or in other areas of the body damaged by UV radiation. Squamous cell carcinomas usually look like small, round, or oval growths on the skin. They can be red, white, tan, or black.

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Actinic Keratosis Symptoms

Actinic Keratosis Symptoms are typically non-specific and include the gradual development of red, scaly patches. As an actinic keratosis evolves, it may erode into a “rodent ulcer” due to constant irritation from rubbing against clothing or other surfaces. Other symptoms include:

• Dry, scaly, and rough patch of skin.
• Flat or slightly raised patch of skin or bump.
• Varied colors of skin, such as red or brown.
• Burning, itching, bleeding or crusting.

Actinic Keratosis Treatment and Detection

Keratosis can be detected clinically by a dermatoscopy or by using a Wood's lamp. A Wood's lamp is used to illuminate the lesion with ultraviolet light, which causes it to fluoresce bright green if it contains high levels of porphyrins from neutrophils.

Dermatoscopy is a non-invasive method of detecting the lesion by taking digital pictures, which are examined more closely on a computer screen by a dermatologist or other specialist. It is considered to be the best method for detecting actinic keratoses.

In order to better identify the location, a dermatologist may perform a skin biopsy on visible lesions to obtain a more accurate diagnosis.

The treatment will depend on the severity of the condition. For most cases of actinic keratoses, topical treatments are sufficient in treating single lesions that don't cause discomfort or pain.

Topical treatment options include:

• Retinoids (e.g. Retin-A, tazarotene)
• Mometasone: This topical corticosteroid may be used to treat actinic keratosis, but may cause side effects like temporary thinning of the skin.
• Curettage and electrodesiccation: This is not usually done alone; instead, it's combined with other treatments such as cryotherapy or topical medications. It involves scraping the top layers of the skin and applying a chemical solution to stop bleeding.
• Cryotherapy: This is another treatment option for actinic keratosis. In most cases, cryotherapy involves using liquid nitrogen to destroy the lesion by freezing it, resulting in scar-like tissue formation.
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