In the USA it is estimated to be the third most common reason for a visit to a dermatology clinic, while in Australia its incidence is estimated at 40-50% of the general population over the age of forty. In fact, in skin types I-III and over forty the incidence increases to 60% and in over sixty it increases to 80%.
In addition to sun exposure, other causes that increase their incidence are immunosuppression (transplant patients, HIV), X-ray radiation (radiologists, interventional cardiologists), genodermatopathies (alphism, xeroderma pigmentosum, etc.), drugs (hydroxyurea, etc.)
There are many treatment methods (but not all actinic hyperkeratosis respond the same to all treatments) such as:
- Cryotherapy
- Dermabrasion and electrocautery
- Surgical removal
- The application of 35% TCA and Jessner’s peelings
- The sublimation of lesions with laser (CO2 and Erbium)
- The topical application of 5-fluorouracil
- The application of diclofenac sodium topically
- Imiquimod
- Ingenol mebutate (Picato gel)
- Photodynamic therapy
The choice of treatment depends on the anatomical location, the size and type of the lesion, the age, the history as well as the will and potential cooperation of our patient. While in the past they were considered precancerous lesions, today the tendency is to treat them as cancerous. According to some authors, they are one of the most frequent forms of skin cancer in the Caucasian race. It is estimated that 5 to 20% of lesions will develop in the next 10-25 years into squamous cell epithelioma. Therefore, it is important for the Dermatologist to diagnose and, of course, treat actinic hyperkeratosis promptly and effectively.
Tilemachos L. Anthopoulos
Dermatologist-Venoretologist
Curator of Dermatology Clinic Nos. E. Dunan’
Head of the Department of Interventional Dermatology