Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects

• Published in: Anais brasileiros de dermatología Vol. 94; no. 6; pp. 637 - 657
• Main Authors: Reinehr, Clarissa Prieto Herman, Bakos, Renato Marchiori
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01-11-2019; Sociedade Brasileira de Dermatologia
• Subjects: Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Continuing Medical education; DERMATOLOGY; Dermoscopy; Dermoscopy - methods; Humans; Keratosis, actinic; Keratosis, Actinic - diagnostic imaging; Keratosis, Actinic - pathology; Keratosis, Actinic - therapy; Neoplasms, squamous cell; Precancerous conditions; Risk Factors; Severity of Illness Index; Skin neoplasms; Skin Neoplasms - diagnostic imaging; Skin Neoplasms - pathology; Dermoscopy; Skin neoplasms; Keratosis, actinic; Precancerous conditions; Neoplasms, squamous cell
• ISSN: 0365-0596; 1806-4841; 1806-4841
• DOI: 10.1016/j.abd.2019.10.004

Actinic keratoses are dysplastic proliferations of keratinocytes with potential for malignant transformation. Clinically, actinic keratoses present as macules, papules, or hyperkeratotic plaques with an erythematous background that occur on photoexposed areas. At initial stages, they may be better identified by palpation rather than by visual inspection. They may also be pigmented and show variable degrees of infiltration; when multiple they then constitute the so-called field cancerization. Their prevalence ranges from 11% to 60% in Caucasian individuals above 40 years. Ultraviolet radiation is the main factor involved in pathogenesis, but individual factors also play a role in the predisposing to lesions appearance. Diagnosis of lesions is based on clinical and dermoscopic examination, but in some situations histopathological analysis may be necessary. The risk of transformation into squamous cell carcinoma is the major concern regarding actinic keratoses. Therapeutic modalities for actinic keratoses include topical medications, and ablative and surgical methods; the best treatment option should always be individualized according to the patient.