Actinic keratoses, also known as solar keratoses or sun-spots are pre-malignant skin lesions, meaning that although they aren't yet cancers, they have the potential to turn into cancers - squamous cell carcinoma.
Australia has the highest prevalence in the world, with most older people expected to develop the lesions at some stage. Usually patients are over the age of 40 before the lesions start to appear.
Actinic keratosis is strongly associated with sun exposure (actinic means radiation-induced) and the face, scalp, backs of hands, arms and leg are the commonest sites.
They usually start as a small pink patch, which can then develop a thin crust, which can be scaly or feel rough. The AK's can be difficult to see and might need to be diagnosed by touch. There is usually no pain but they may be sensitive to sunlight or if they are rubbed.
These lesions can be solitary or numbered in the hundreds, depending on the skin type and the amount of previous sun exposure.
As most squamous cell carcinomas arise from AK's, anyone with multiple AK lesions should have regular follow ups, because they have a greater risk of skin cancer in general. AK's should be removed at an early stage rather than waiting to see if they become cancerous.
It can be difficult to distinguish these lesions clinically from squamous cell carcinoma. Clues that AK's may have become cancerous are thickening, tenderness, bleeding or ulceration of the lesion. Where there is doubt, or if an SCC is suspected, a punch biopsy may be performed.
Actinic keratoses must be treated with sun avoidance, and either with cryotherapy (liquid nitrogen freezing), or by using creams such as Solaraze or Aldara or by curettage
If you have any concern, or want to learn how to monitor your skin, please do not wait any longer, contact us today.
