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Actinic keratosis

MedGen UID:
9627
•Concept ID:
C0022602
•
Neoplastic Process
Synonyms: Actinic Keratoses; Actinic Keratosis; Keratoses, Actinic; Keratosis, Actinic
SNOMED CT: Actinic keratosis (201101007); Atrophic keratosis (201101007); AK - Actinic keratosis (201101007); SK - Solar keratosis (201101007); Hyperplastic keratosis (201101007); Senile keratoma (201101007); Actinic keratosis (856006); Solar keratosis (856006); Senile keratoma (856006); Keratinocytic intraepidermal neoplasia (856006); Solar keratosis (201101007)
 
HPO: HP:0025127
Monarch Initiative: MONDO:0005173

Definition

A scaly, crusty lesion caused by damage from the ultraviolet radiation of the sun, with typical location on sun-exposed areas of the skin. Actinic keratosis lesions are often elevated, rough, and wartlike, and may be red, or occasionally tan, pink, or flesh-toned in color. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVActinic keratosis

Conditions with this feature

Familial cutaneous telangiectasia and oropharyngeal predisposition cancer syndrome
MedGen UID:
482833
•Concept ID:
C3281203
•
Neoplastic Process
Patients with this syndrome develop cutaneous telangiectases in infancy with patchy alopecia over areas of affected skin, thinning of the lateral eyebrows, and mild dental and nail anomalies. Affected individuals are at increased risk of developing oropharyngeal cancer, and other malignancies have been reported as well (Tanaka et al., 2012).
See: Condition Record
Familial cutaneous telangiectasia and oropharyngeal predisposition cancer syndrome

Professional guidelines

PubMed

Treatment of actinic keratosis: a systematic review.
Worley B, Harikumar V, Reynolds K, Dirr MA, Christensen RE, Anvery N, Yi MD, Poon E, Alam M
Arch Dermatol Res 2023 Jul;315(5):1099-1108. Epub 2022 Dec 1 doi: 10.1007/s00403-022-02490-5. PMID: 36454335
Lentigo maligna: diagnosis and treatment.
De Luca EV, Perino F, Di Stefani A, Coco V, Fossati B, Peris K
G Ital Dermatol Venereol 2020 Apr;155(2):179-189. Epub 2018 Apr 19 doi: 10.23736/S0392-0488.18.06003-0. PMID: 29683288
Albinism: epidemiology, genetics, cutaneous characterization, psychosocial factors.
Marçon CR, Maia M
An Bras Dermatol 2019 Sep-Oct;94(5):503-520. Epub 2019 Sep 30 doi: 10.1016/j.abd.2019.09.023. PMID: 31777350Free PMC Article

Recent clinical studies

Etiology

Treatment of actinic keratosis: a systematic review.
Worley B, Harikumar V, Reynolds K, Dirr MA, Christensen RE, Anvery N, Yi MD, Poon E, Alam M
Arch Dermatol Res 2023 Jul;315(5):1099-1108. Epub 2022 Dec 1 doi: 10.1007/s00403-022-02490-5. PMID: 36454335
Guidelines of care for the management of actinic keratosis.
Eisen DB, Asgari MM, Bennett DD, Connolly SM, Dellavalle RP, Freeman EE, Goldenberg G, Leffell DJ, Peschin S, Sligh JE, Wu PA, Frazer-Green L, Malik S, Schlesinger TE
J Am Acad Dermatol 2021 Oct;85(4):e209-e233. Epub 2021 Apr 2 doi: 10.1016/j.jaad.2021.02.082. PMID: 33820677
Field cancerization: Definition, epidemiology, risk factors, and outcomes.
Willenbrink TJ, Ruiz ES, Cornejo CM, Schmults CD, Arron ST, Jambusaria-Pahlajani A
J Am Acad Dermatol 2020 Sep;83(3):709-717. Epub 2020 May 7 doi: 10.1016/j.jaad.2020.03.126. PMID: 32387665
Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects.
Reinehr CPH, Bakos RM
An Bras Dermatol 2019 Nov-Dec;94(6):637-657. Epub 2019 Nov 6 doi: 10.1016/j.abd.2019.10.004. PMID: 31789244Free PMC Article
Nicotinamide for photoprotection and skin cancer chemoprevention: A review of efficacy and safety.
Snaidr VA, Damian DL, Halliday GM
Exp Dermatol 2019 Feb;28 Suppl 1:15-22. doi: 10.1111/exd.13819. PMID: 30698874

Diagnosis

Current therapies for actinic keratosis.
Dianzani C, Conforti C, Giuffrida R, Corneli P, di Meo N, Farinazzo E, Moret A, Magaton Rizzi G, Zalaudek I
Int J Dermatol 2020 Jun;59(6):677-684. Epub 2020 Feb 3 doi: 10.1111/ijd.14767. PMID: 32012240
Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects.
Reinehr CPH, Bakos RM
An Bras Dermatol 2019 Nov-Dec;94(6):637-657. Epub 2019 Nov 6 doi: 10.1016/j.abd.2019.10.004. PMID: 31789244Free PMC Article
Randomized Trial of Four Treatment Approaches for Actinic Keratosis.
Jansen MHE, Kessels JPHM, Nelemans PJ, Kouloubis N, Arits AHMM, van Pelt HPA, Quaedvlieg PJF, Essers BAB, Steijlen PM, Kelleners-Smeets NWJ, Mosterd K
N Engl J Med 2019 Mar 7;380(10):935-946. doi: 10.1056/NEJMoa1811850. PMID: 30855743
Dermatoscopy of Neoplastic Skin Lesions: Recent Advances, Updates, and Revisions.
Weber P, Tschandl P, Sinz C, Kittler H
Curr Treat Options Oncol 2018 Sep 20;19(11):56. doi: 10.1007/s11864-018-0573-6. PMID: 30238167Free PMC Article
Real-world approach to actinic keratosis management: practical treatment algorithm for office-based dermatology.
Dirschka T, Gupta G, Micali G, Stockfleth E, Basset-Séguin N, Del Marmol V, Dummer R, Jemec GBE, Malvehy J, Peris K, Puig S, Stratigos AJ, Zalaudek I, Pellacani G
J Dermatolog Treat 2017 Aug;28(5):431-442. Epub 2016 Nov 13 doi: 10.1080/09546634.2016.1254328. PMID: 27796187

Therapy

Treatment of actinic keratosis: a systematic review.
Worley B, Harikumar V, Reynolds K, Dirr MA, Christensen RE, Anvery N, Yi MD, Poon E, Alam M
Arch Dermatol Res 2023 Jul;315(5):1099-1108. Epub 2022 Dec 1 doi: 10.1007/s00403-022-02490-5. PMID: 36454335
Guidelines of care for the management of actinic keratosis.
Eisen DB, Asgari MM, Bennett DD, Connolly SM, Dellavalle RP, Freeman EE, Goldenberg G, Leffell DJ, Peschin S, Sligh JE, Wu PA, Frazer-Green L, Malik S, Schlesinger TE
J Am Acad Dermatol 2021 Oct;85(4):e209-e233. Epub 2021 Apr 2 doi: 10.1016/j.jaad.2021.02.082. PMID: 33820677
Field cancerization: Treatment.
Cornejo CM, Jambusaria-Pahlajani A, Willenbrink TJ, Schmults CD, Arron ST, Ruiz ES
J Am Acad Dermatol 2020 Sep;83(3):719-730. Epub 2020 May 6 doi: 10.1016/j.jaad.2020.03.127. PMID: 32387663
The Role of Nicotinamide in Cancer Chemoprevention and Therapy.
Nikas IP, Paschou SA, Ryu HS
Biomolecules 2020 Mar 20;10(3) doi: 10.3390/biom10030477. PMID: 32245130Free PMC Article
Nicotinamide for photoprotection and skin cancer chemoprevention: A review of efficacy and safety.
Snaidr VA, Damian DL, Halliday GM
Exp Dermatol 2019 Feb;28 Suppl 1:15-22. doi: 10.1111/exd.13819. PMID: 30698874

Prognosis

Incidence and Treatment of Actinic Keratosis in Older Adults With Medicare Coverage.
Navsaria LJ, Li Y, Nowakowska MK, Hinkston CL, Wheless L, Giordano SH, Wehner MR
JAMA Dermatol 2022 Sep 1;158(9):1076-1078. doi: 10.1001/jamadermatol.2022.2555. PMID: 35895043Free PMC Article
Risk of Invasive Cutaneous Squamous Cell Carcinoma After Different Treatments for Actinic Keratosis: A Secondary Analysis of a Randomized Clinical Trial.
Ahmady S, Jansen MHE, Nelemans PJ, Kessels JPHM, Arits AHMM, de Rooij MJM, Essers BAB, Quaedvlieg PJF, Kelleners-Smeets NWJ, Mosterd K
JAMA Dermatol 2022 Jun 1;158(6):634-640. doi: 10.1001/jamadermatol.2022.1034. PMID: 35475852Free PMC Article
Field cancerization: Definition, epidemiology, risk factors, and outcomes.
Willenbrink TJ, Ruiz ES, Cornejo CM, Schmults CD, Arron ST, Jambusaria-Pahlajani A
J Am Acad Dermatol 2020 Sep;83(3):709-717. Epub 2020 May 7 doi: 10.1016/j.jaad.2020.03.126. PMID: 32387665
Skin cancer precursor immunotherapy for squamous cell carcinoma prevention.
Rosenberg AR, Tabacchi M, Ngo KH, Wallendorf M, Rosman IS, Cornelius LA, Demehri S
JCI Insight 2019 Mar 21;4(6) doi: 10.1172/jci.insight.125476. PMID: 30895944Free PMC Article
Randomized Trial of Four Treatment Approaches for Actinic Keratosis.
Jansen MHE, Kessels JPHM, Nelemans PJ, Kouloubis N, Arits AHMM, van Pelt HPA, Quaedvlieg PJF, Essers BAB, Steijlen PM, Kelleners-Smeets NWJ, Mosterd K
N Engl J Med 2019 Mar 7;380(10):935-946. doi: 10.1056/NEJMoa1811850. PMID: 30855743

Clinical prediction guides

Treatment considerations in actinic keratosis.
Goldenberg G
J Eur Acad Dermatol Venereol 2017 Mar;31 Suppl 2:12-16. doi: 10.1111/jdv.14152. PMID: 28263018
Actinic Keratosis Pathogenesis Update and New Patents.
Cantisani C, Paolino G, Melis M, Faina V, Romaniello F, Didona D, Cardone M, Calvieri S
Recent Pat Inflamm Allergy Drug Discov 2016;10(1):40-48. doi: 10.2174/1872213x10666160504104825. PMID: 27142784
Safety and tolerability of ingenol mebutate in the treatment of actinic keratosis.
Berman B
Expert Opin Drug Saf 2015;14(12):1969-78. Epub 2015 Nov 2 doi: 10.1517/14740338.2015.1108962. PMID: 26524598
Actinic keratosis and squamous cell carcinoma: clinical and pathological features.
Filosa A, Filosa G
G Ital Dermatol Venereol 2015 Aug;150(4):379-84. Epub 2015 Jun 23 PMID: 26099352
Cutaneous cryosurgery.
Zimmerman EE, Crawford P
Am Fam Physician 2012 Dec 15;86(12):1118-24. PMID: 23316984

Recent systematic reviews

Treatment of actinic keratosis: a systematic review.
Worley B, Harikumar V, Reynolds K, Dirr MA, Christensen RE, Anvery N, Yi MD, Poon E, Alam M
Arch Dermatol Res 2023 Jul;315(5):1099-1108. Epub 2022 Dec 1 doi: 10.1007/s00403-022-02490-5. PMID: 36454335
Evidence-Based Clinical Practice Guidelines for Laser-Assisted Drug Delivery.
Labadie JG, Ibrahim SA, Worley B, Kang BY, Rakita U, Rigali S, Arndt KA, Bernstein E, Brauer JA, Chandra S, Didwania A, DiGiorgio C, Donelan M, Dover JS, Galadari H, Geronemus RG, Goldman MP, Haedersdal M, Hruza G, Ibrahimi OA, Kauvar A, Kelly KM, Krakowski AC, Miest R, Orringer JS, Ozog DM, Ross EV, Shumaker PR, Sobanko JF, Suozzi K, Taylor MB, Teng JMC, Uebelhoer NS, Waibel J, Wanner M, Ratchev I, Christensen RE, Poon E, Miller CH, Alam M
JAMA Dermatol 2022 Oct 1;158(10):1193-1201. doi: 10.1001/jamadermatol.2022.3234. PMID: 35976634
Effect of Nicotinamide in Skin Cancer and Actinic Keratoses Chemoprophylaxis, and Adverse Effects Related to Nicotinamide: A Systematic Review and Meta-Analysis.
Mainville L, Smilga AS, Fortin PR
J Cutan Med Surg 2022 May-Jun;26(3):297-308. Epub 2022 Feb 8 doi: 10.1177/12034754221078201. PMID: 35134311Free PMC Article
Use of Topical Calcipotriol Plus 5-Fluorouracil in the Treatment of Actinic Keratosis: A Systematic Review.
Mohney L, Singh R, Grada A, Feldman S
J Drugs Dermatol 2022 Jan 1;21(1):60-65. doi: 10.36849/JDD.2022.6632. PMID: 35005863
Guidelines of care for the management of actinic keratosis.
Eisen DB, Asgari MM, Bennett DD, Connolly SM, Dellavalle RP, Freeman EE, Goldenberg G, Leffell DJ, Peschin S, Sligh JE, Wu PA, Frazer-Green L, Malik S, Schlesinger TE
J Am Acad Dermatol 2021 Oct;85(4):e209-e233. Epub 2021 Apr 2 doi: 10.1016/j.jaad.2021.02.082. PMID: 33820677

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