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Actinic Keratosis

A thick, scaly patch of skin that may become cancer. It usually forms on areas exposed to the sun, such as the face, scalp, back of the hands, or chest. It is most common in people with fair skin.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Actinic Keratosis

Actinic keratosis is a skin condition that is not cancer, but sometimes changes into squamous cell carcinoma. It usually occurs in areas that have been exposed to the sun, such as the face, the back of the hands, and the lower lip. It looks like rough, red, pink, or brown scaly patches on the skin that may be flat or raised, or the lower lip cracks and peels and is not helped by lip balm or petroleum jelly....Read more about Actinic Keratosis

What works? Research summarized

Evidence reviews

Ingenol Mebutate (Picato): Topical Treatment of Non-hyperkeratotic, Non-hypertrophic Actinic Keratosis in Adults [Internet]

The objective of this systematic review is to examine the beneficial and harmful effects of ingenol mebutate once daily for the topical treatment of non-hyperkeratotic, non-hypertrophic actinic keratosis (AK) for the face and scalp (0.015% gel, three-day treatment) and for the trunk and extremities (0.05% gel, two-day treatment) in adult patients.

Interventions for actinic keratoses

Actinic keratoses are a skin disease caused by long‐term sun exposure. Damaged skin shows small, red, rough, scaly, flat spots called actinic keratoses or lesions, which feel like patches of dry skin. Symptoms such as bleeding and pain can be associated with actinic keratoses. Moreover, actinic keratoses have the potential to develop into skin cancer if left untreated. The reasons for treatment may include cosmetic appearance, relief of symptoms, or prevention of skin cancer. Treatment can be directed either at individual lesions or to larger areas of the skin where several visible and less visible lesions occur (field‐directed treatment).

Comparison of topical 5-fluorouracil formulations in actinic keratosis treatment

The authors concluded that there was inadequate information to formulate a decision on the comparative efficacy of 0.5% and 5% 5-fluorouracil in patients with multiple actinic keratoses of the face and scalp. The synthesis suffered from significant limitations that provided a substantial threat to the overall reliability of the review.

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Summaries for consumers

Ingenol mebutate (Picato) for actinic keratosis: Overview

Ingenol mebutate (trade name: Picato) gel has been approved in Germany since November 2012 for the treatment of certain types of actinic keratosis.

Interventions for actinic keratoses

Actinic keratoses are a skin disease caused by long‐term sun exposure. Damaged skin shows small, red, rough, scaly, flat spots called actinic keratoses or lesions, which feel like patches of dry skin. Symptoms such as bleeding and pain can be associated with actinic keratoses. Moreover, actinic keratoses have the potential to develop into skin cancer if left untreated. The reasons for treatment may include cosmetic appearance, relief of symptoms, or prevention of skin cancer. Treatment can be directed either at individual lesions or to larger areas of the skin where several visible and less visible lesions occur (field‐directed treatment).

The course of non-melanoma skin cancer

Non-melanoma skin cancers include basal cell cancer and squamous cell cancer. Basal cell cancer is the most common kind of skin cancer, but it usually grows slowly. Squamous cell cancer is somewhat more aggressive. Most of these tumors are discovered before they spread to other parts of the body, though.Basal cell cancerBasal cell cancer (basal cell carcinoma) mainly affects people over the age of 40 and is most commonly found on the face, neck or other parts of the head that are frequently exposed to sunlight. It usually grows slowly and stays in the area where it first developed. So it is generally discovered at a stage where it can be completely removed in surgery. But it is still not totally harmless: if it is only treated at a later stage, or not treated at all, it can enter deeper layers of tissue. This can cause damage to things like your nose, eyes and facial bones.Basal cell cancer rarely spreads to other parts of the body (metastasis), so it is rarely fatal. Only about 1 out of 1,000 people who have basal cell cancer die of it.Squamous cell cancerSquamous cell cancer (squamous cell carcinoma) is particularly common in older people over the age of 60. It nearly always develops on parts of the body that are exposed to the sun, especially on the face, ears, lower lip and the back of your hands.Like basal cell cancer, squamous cell cancer grows where it first developed, damaging nearby tissue. But it is more aggressive than basal cell cancer, particularly if it grows in an old scar, a sore, or on your lips or ears.If left untreated, there is a danger that the cancer might spread to other parts of the body. But most squamous cell cancer tumors are discovered before metastases develop. Then it is usually quite easy to treat them. About 40 to 50 out of 1,000 people with this type of cancer die of it.

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Terms to know

Nonmelanoma Skin Cancer
Skin cancer that forms in the lower part of the epidermis (the outer layer of the skin) or in squamous cells, but not in melanocytes (skin cells that make pigment).
Skin
The outer covering of the body that protects it from the environment.
Squamous Cell Carcinoma
Cancer that begins in squamous cells. Squamous cells are thin, flat cells that look like fish scales, and are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the lining of the respiratory and digestive tracts.
Squamous Cells
Flat cell that looks like a fish scale under a microscope. These cells cover inside and outside surfaces of the body. They are found in the tissues that form the surface of the skin, the lining of the hollow organs of the body (such as the bladder, kidney, and uterus), and the passages of the respiratory and digestive tracts.

More about Actinic Keratosis

Photo of an adult

Also called: Atrophic keratosis, Hyperplastic keratosis, Senile hyperkeratosis, Senile keratoma, Solar keratosis, Senile keratosis, AK, SK

Other terms to know: See all 4
Nonmelanoma Skin Cancer, Skin, Squamous Cell Carcinoma

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