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Chernyakova O.I.

Mechnikov North-Western State Medical University

Suvorova A.A.

Mechnikov North-Western State Medical University

Vashkevich A.A.

Mechnikov North-Western State Medical University

Raznatovsky K.I.

Mechnikov North-Western State Medical University

Reztsova P.A.

Mechnikov North-Western State Medical University

Alikbaev T.Z.

Pirogov Clinic of High Medical Technologies of the Saint Petersburg State University

Actinic keratosis. Features of pathogenesis, modern approaches to diagnosis and therapy

Authors:

Chernyakova O.I., Suvorova A.A., Vashkevich A.A., Raznatovsky K.I., Reztsova P.A., Alikbaev T.Z.

More about the authors

Read: 1011 times


To cite this article:

Chernyakova OI, Suvorova AA, Vashkevich AA, Raznatovsky KI, Reztsova PA, Alikbaev TZ. Actinic keratosis. Features of pathogenesis, modern approaches to diagnosis and therapy. Russian Journal of Clinical Dermatology and Venereology. 2025;24(2):227‑234. (In Russ.)
https://doi.org/10.17116/klinderma202524021227

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References:

  1. Flohil SC, van der Leest RJ, Dowlatshahi EA, Hofman A, de Vries E, Nijsten T. Prevalence of actinic keratosis and its risk factors in the general population: the Rotterdam Study. J Investig Dermatol. 2013;133:1971-1978. https://doi.org/10.1038/jid.2013.134
  2. Zhao Y, Li CY, Wen CM, Wei YB, Li RY, Wang G, Tu P. The prevalence of actinic keratosis in patients visiting dermatologists in two hospitals in China. Br J Dermatol. 2016 May;174(5):1005-1010. https://doi.org/10.1111/bjd.14344
  3. Kaprin AD, Starinsky VV, Petrova GV, eds. The status of cancer care for the population of Russia in 2017. Moscow. 2018. (In Russ.).
  4. Leffell DJ. The scientific basis of skin cancer. J Am Acad Dermatol. 2000 Jan; 42(1 Pt 2):18-22.  https://doi.org/10.1067/mjd.2000.103340
  5. Salasche SJ. Epidemiology of actinic keratoses and squamous cell carcinoma. J Am Acad Dermatol. 2000 Jan;42(1 Pt 2):4-5.  https://doi.org/10.1067/mjd.2000.103342
  6. Gutzmer R, Wiegand S, Kölbl O, Wermker K, Heppt M, Berking C. Actinic Keratosis and Cutaneous Squamous Cell Carcinoma. Dtsch Arztebl Int. 2019 Sep 13;116(37):616-626.  https://doi.org/10.3238/arztebl.2019.0616
  7. Morelló Vicente A, Oteiza Rius I, Aguado Gil L. Actinic Keratosis in Solid Organ Transplant Recipients: A Medical Literature Review. Actas Dermosifiliogr. 2023 Nov 2:S0001-7310(23)00853-0. English, Spanish. https://doi.org/10.1016/j.ad.2023.10.021
  8. Parrish JA. Immunosuppression, skin cancer, and ultraviolet A radiation. N Engl J Med. 2005 Dec 22;353(25):2712-2713. https://doi.org/10.1056/NEJMcibr054224
  9. Melkonian S, Argos M, Pierce BL, Chen Y, Islam T, Ahmed A, Syed EH, Parvez F, Graziano J, Rathouz PJ, Ahsan H. A prospective study of the synergistic effects of arsenic exposure and smoking, sun exposure, fertilizer use, and pesticide use on risk of premalignant skin lesions in Bangladeshi men. Am J Epidemiol. 2011 Jan 15;173(2):183-191.  https://doi.org/10.1093/aje/kwq357
  10. Weissenborn SJ, Nindl I, Purdie K, et al. Human papillomavirus-DNA loads in actinic keratoses exceed those in non-melanoma skin cancers. J Invest Dermatol. 2005 Jul;125(1):93-97.  https://doi.org/10.1111/j.0022-202X.2005.23733.x
  11. McBride P, Neale R, Pandeya N, Green A. Sun-related factors, betapapillomavirus, and actinic keratoses: a prospective study. Arch Dermatol. 2007 Jul;143(7):862-868.  https://doi.org/10.1001/archderm.143.7.862
  12. Rstom S, Abdalla B, Blumetti T, Matos L, Pinhal M, Paschoal F. Dermoscopy and Reflectance Confocal Microscopy in Actinic Keratosis, Intraepithelial Carcinoma, and Invasive Squamous Cell Carcinoma. J Drugs Dermatol. 2022 Mar 01;21(3):259-268. 
  13. Hashim PW, Chen T, Rigel D, Bhatia N, Kircik LH. Actinic Keratosis: Current Therapies and Insights Into New Treatments. J Drugs Dermatol. 2019 May 01;18(5):s161-166. 
  14. Nguyen M, Sandhu SS, Sivamani RK. Clinical utility of daylight photodynamic therapy in the treatment of actinic keratosis — a review of the literature. Clin Cosmet Investig Dermatol. 2019;12:427-435.  https://doi.org/10.2147/CCID.S167498
  15. Padilla RS, Sebastian S, Jiang Z, et al. Gene expression patterns of normal human skin, actinic keratosis and squamous cell carcinoma. Arch Dermatol. 2010;146(3):288-293.  https://doi.org/10.1001/archdermatol.2009.378
  16. Frost CA, Green AC, Williams GM. The prevalence and determinants of solar keratoses at a subtropical latitude. Br J Dermatol. 1998 Dec;139(6): 1033-1039. https://doi.org/10.1046/j.1365-2133.1998.02560.x
  17. Salasche SJ. Epidemiology of actinic keratoses and squamous cell carcinoma. J Am Acad Dermatol. 2000 Jan;42(1 Pt 2):6-7.  https://doi.org/10.1067/mjd.2000.103342
  18. Roewert-Huber J, Stockfleth E, Kerl H. Pathology and pathobiology of actinic (solar) keratosis — an update. Br J Dermatol. 2007 Dec;157(2):18-20.  https://doi.org/10.1111/j.1365-2133.2007.08267.x
  19. James C, Crawford R, Martika M. Actinic Keratosis. WHO Pathology and Genetics, Skin Tumors. Lyon: IARC Press; 2006:30-33. 
  20. Casari A, Chester J, Pellacani G. Actinic Keratosis and Non-Invasive Diagnostic Techniques: An Update. Biomedicines. 2018 Jan 8;6(1):8.  https://doi.org/10.3390/biomedicines6010008
  21. Zalaudek I, Giacomel J, Argenziano G, Hofmann-Wellenhof R, Micantonio T, Di Stefani A, Oliviero M, Rabinovitz H, Soyer HP, Peris K. Dermoscopy of facial nonpigmented actinic keratosis. Br J Dermatol. 2006;155: 951-956.  https://doi.org/10.1111/j.1365-2133.2006.07426.x
  22. Zalaudek I, Argenziano G. Dermoscopy of actinic keratosis, intraepidermal carcinoma and squamous cell carcinoma. Curr Probl Dermatol. 2015;46:70-76.  https://doi.org/10.1159/000366539
  23. Zalaudek I, Ferrara G, Leinweber B, Mercogliano A, D’Ambrosio A, Argenziano G. Pitfalls in the clinical and dermoscopic diagnosis of pigmented actinic keratosis. J Am Acad Dermatol. 2005;53:1071-1074. https://doi.org/10.1016/j.jaad.2005.08.052
  24. Akay BN, Kocyigit P, Heper AO, Erdem C. Dermatoscopy of flat pigmented facial lesions: Diagnostic challenge between pigmented actinic keratosis and lentigo maligna. Br J Dermatol. 2010;163:1212-1217. https://doi.org/10.1111/j.1365-2133.2010.10025.x
  25. Balagula Y, Braun RP, Rabinovitz HS, Dusza SW, Scope A, Liebman TN, Mordente I, Siamas K, Marghoob AA. The significance of crystalline/chrysalis structures in the diagnosis of melanocytic and nonmelanocytic lesions. J Am Acad Dermatol. 2012 Aug;67(2):194.e1-8.  https://doi.org/10.1016/j.jaad.2011.04.039
  26. Zalaudek I, Giacomel J, Schmid K, Bondino S, Rosendahl C, Cavicchini S, Tourlaki A, Gasparini S, Bourne P, Keir J, Kittler H, Eibenschutz L, Catricalà C, Argenziano G. Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: a progression model. J Am Acad Dermatol. 2012 Apr;66(4):589-597.  https://doi.org/10.1016/j.jaad.2011.02.011
  27. Hashim PW, Chen T, Rigel D, Bhatia N, Kircik LH. Actinic Keratosis: Current Therapies and Insights Into New Treatments. J Drugs Dermatol. 2019 May 01;18(5):s161-166. 
  28. Zhu T, Guffey D, Novicoff W, Hendrix J. Concordance in Distinguishing Actinic Keratosis from Squamous Cell Carcinoma in Situ on Mohs Histological Frozen Sections. J Drugs Dermatol. 2023 Feb 01;22(2):190-194.  https://doi.org/10.36849/JDD.7084
  29. Schmitz L, Broganelli P, Boada A. Classifying Actinic Keratosis: What the Reality of Everyday Clinical Practice Shows Us. J Drugs Dermatol. 2022 Aug 01; 21(8):845-849.  https://doi.org/10.36849/JDD.6704
  30. Yantsos VA, Conrad N, Zabawski E, Cockerell CJ. Incipient intraepidermal cutaneous squamous cell carcinoma: a proposal for reclassifying and grading solar (actinic) keratoses. Semin Cutan Med Surg. 1999 Mar;18(1):3-14. 
  31. Röwert-Huber J, Patel MJ, Forschner T, Ulrich C, Eberle J, Kerl H, Sterry W, Stockfleth E. Actinic keratosis is an early in situ squamous cell carcinoma: a proposal for reclassification. Br J Dermatol. 2007 May;156(3):8-12.  https://doi.org/10.1111/j.1365-2133.2007.07860.x
  32. Zalaudek I, Piana S, Moscarella E, Longo C, Zendri E, Castagnetti F, Pellacani G, Lallas A, Argenziano G. Morphologic grading and treatment of facial actinic keratosis. Clin Dermatol. 2014 Jan-Feb;32(1):80-87.  https://doi.org/10.1016/j.clindermatol.2013.05.028
  33. Dirschka T, Gupta G, Micali G, Stockfleth E, Basset-Séguin N, Del Marmol V et al. Real-world approach to actinic keratosis management: practical treatment algorithm for office-based dermatology. J Dermatolog Treat. 2017 Aug;28(5):431-442.  https://doi.org/10.1080/09546634.2016.1254328
  34. Pellacani G, Neri L, Longo C. Comment to: ‘Evidence and consensus based (S3) Guidelines for the Treatment of Actinic Keratosis’. J Eur Acad Dermatol Venereol. 2016 Nov;30(11):e114. https://doi.org/10.1111/jdv.13355
  35. Noels EC, Hollestein LM, van Egmond S, Lugtenberg M, van Nistelrooij LPJ, Bindels PJE, van der Lei J, Stern RS, Nijsten T, Wakkee M. Healthcare utilization and management of actinic keratosis in primary and secondary care: a complementary database analysis. Br J Dermatol. 2019 Sep;181(3):544-553.  https://doi.org/10.1111/bjd.17632
  36. Arisi M, Guasco Pisani E, Calzavara-Pinton P, Zane C. Cryotherapy for Actinic Keratosis: Basic Principles and Literature Review. Clin Cosmet Investig Dermatol. 2022;15:357.  https://doi.org/10.2147/CCID.S267190
  37. Actikerall. Summary of product characteristics. 2014. Accessed March 06, 2024. https://www.medicinesorguk/emc/medicine/24614
  38. Stockfleth E, Kerl H, Zwingers T, Willers C. Low-dose 5-fluorouracil in combination with salicylic acid as a new lesion-directed option to treat topically actinic keratoses: histological and clinical study results. Br J Dermatol. 2011 Nov;165(5):1101-1108. https://doi.org/10.1111/j.1365-2133.2011.10387.x
  39. Schon M, Bong AB, Drewniok C, et al. Tumor-selective induction of apoptosis and the small-molecule immune response modifier imiquimod. J Natl Cancer Inst. 2003 Aug 6;95(15):1138-1149. https://doi.org/10.1093/jnci/djg016
  40. Alomar A, Bichel J, McRae S. Vehicle-controlled, randomized, double-blind study to assess safety and efficacy of imiquimod 5% cream applied once daily 3 days per week in one or two courses of treatment of actinic keratoses on the head. Br J Dermatol. 2007 Jul;157(1):133-141.  https://doi.org/10.1111/j.1365-2133.2007.07942.x
  41. Marmur ES, Schmults CD, Goldberg DJ. A review of laser and photodynamic therapy for the treatment of nonmelanoma skin cancer. Dermatol Surg. 2004 Feb;30(2 Pt 2):264-271.  https://doi.org/10.1111/j.1524-4725.2004.30083.x
  42. Nestor MS, Berman B, Patel J, Lawson A. Safety and Efficacy of Aminolevulinic Acid 10% Topical Gel versus Aminolevulinic Acid 20% Topical Solution Followed by Blue-light Photodynamic Therapy for the Treatment of Actinic Keratosis on the Face and Scalp: A Randomized, Double-blind Study. J Clin Aesthet Dermatol. 2019;12:32. 
  43. Micali G, Lacarrubba F, Nasca MR, Schwartz RA. Topical pharmacotherapy for skin cancer: part I. Pharmacology. J Am Acad Dermatol. 2014 Jun; 70(6):965-1012. https://doi.org/10.1016/j.jaad.2013.12.045
  44. Rivers JK, Arlette J, Shear N, Guenther L, Carey W, Poulin Y. Topical treatment of actinic keratoses with 3.0% diclofenac in 2.5% hyaluronan gel. Br J Dermatol. 2002 Jan;146(1):94-100.  https://doi.org/10.1046/j.1365-2133.2002.04561.x
  45. Lawrence N, Cox SE, Cockerell CJ, et al. A comparison of the efficacy and safety of Jessner’s solution and 35% trichloroacetic acid vs 5% fluorouracil in the treatment of widespread facial actinic keratoses. Arch Dermatol. 1995;131:176. 
  46. Holzer G, Pinkowicz A, Radakovic S, et al. Randomized controlled trial comparing 35% trichloroacetic acid peel and 5-aminolaevulinic acid photodynamic therapy for treating multiple actinic keratosis. Br J Dermatol. 2017;176:1155. https://doi.org/10.1111/bjd.15272
  47. Hantash BM, Stewart DB, Cooper ZA, et al. Facial resurfacing for nonmelanoma skin cancer prophylaxis. Arch Dermatol. 2006;142:976.  https://doi.org/10.1001/archderm.142.8.976
  48. Prens SP, de Vries K, Neumann HA, Prens EP. Non-ablative fractional resurfacing in combination with topical tretinoin cream as a field treatment modality for multiple actinic keratosis: a pilot study and a review of other field treatment modalities. J Dermatolog Treat. 2013;24:227.  https://doi.org/10.3109/09546634.2012.687088
  49. Jorizzo J, Weiss J, Furst K, et al. Effect of a 1-week treatment with 0.5% topical fluorouracil on occurrence of actinic keratosis after cryosurgery: a randomized, vehicle-controlled clinical trial. Arch Dermatol. 2004;140:813.  https://doi.org/10.1001/archderm.140.7.813
  50. Jorizzo J, Weiss J, Vamvakias G. One-week treatment with 0.5% fluorouracil cream prior to cryosurgery in patients with actinic keratoses: a double-blind, vehicle-controlled, long-term study. J Drugs Dermatol. 2006;5:133. 
  51. Tan JK, Thomas DR, Poulin Y, et al. Efficacy of imiquimod as an adjunct to cryotherapy for actinic keratoses. J Cutan Med Surg. 2007;11:195.  https://doi.org/10.2310/7750.2007.00033
  52. Tanghetti EA, Hamann C, Tanghetti M. A Controlled Comparison Study of Topical Fluourouracil 5% Cream Pre-Treatment of Aminolevulinic Acid/Photodynamic Therapy for Actinic Keratosis. J Drugs Dermatol. 2015;14:1241.
  53. Tanaka N, Ohata C, Ishii N, et al. Comparative study for the effect of photodynamic therapy, imiquimod immunotherapy and combination of both therapies on 40 lesions of actinic keratosis in Japanese patients. J Dermatol. 2013;40:962.  https://doi.org/10.1111/1346-8138.12310
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