Actinic keratosis

Actinic keratoses (AK) are pink, relatively poorly demarcated, scaly patches and plaques on the sun-exposed skin.

When markedly hyperkeratotic, they can be tender when palpated.

Actinic keratoses can spontaneously regress and can, without treatment, occasionally evolve into invasive squamous carcinoma.

Treatment:

• Liquid nitrogen cryotherapy is the treatment of choice for the isolated actinic keratosis.
• Multiple AK's respond to topical 5% 5-fluorouracil cream bid for three weeks, followed by a resolution of the inflammatory reaction and retreatment. Retreatment is important, if recurrences are to be reduced.
• 10% Masoprocol cream bid for four weeks is an alternative to 5% 5-fluorouracil.
• Imiquimod cream is shown to be effective
• Photodynamic therapy is another possible treatment
• As actinic keratoses are secondary to ultraviolet light damage, the use of broad spectrum sunscreens is recommended.

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