April 8, 2018

Actinic (Solar) Keratosis

Actinic Keratosis

Actinic Keratosis is formed from years of exposure to the sun. It is rough, crusty, and scaly looking, and is commonly found on the face, ears, lips, forearms, scalp, neck, and back of the hands.

It will often first appear as a small spot on the skin.It is usually only seen in older adults. The signs that one may have actinic keratosis are a dry, rough, scaly patch on the skin that is usually less than an inch in diameter. It could have a wart like surface, and is flat to slightly raised on the skin. It might itch or burn, and coloured pink, brown, red or flesh coloured.  If one suspects they do have actinic keratosis, they should have the area checked out by a dermatologist before skin cancer develops. If not treated right away, the actinic keratosis could develop into squamous cell carcinoma, which is treatable if caught right away.  If left untreated, one has a 20% risk of progression to squamous cell carcinoma.

Prevention

Actinic keratosis can be prevented.  Sunscreen should always be worn, at least 20 minutes before sun exposure.  Reapply every 2 hours.  Limit your time in the sun and always make sure your SPF is at least 30.   Avoid the sun during the noon hours when the UV rays are the most powerful.  Wear hats and sunglasses, and long light sleeved clothing. Do not use tanning beds or booths, as they do cause actinic keratosis.

Treatment

A doctor will usually just examine the area to determine if actinic keratosis is present.  However, in some cases biopsies or other testing may be done.  With a biopsy, a small segment of skin will be collected from the area after numbing it.  It will be sent to a lab to be examined.  Within a week one should have the results.

There are several medications that can be prescribed for actinic keratosis.  Those include any of the following:

  • Diclofenac gel
  • Ingenol mebutate gel
  • Imiquimod cream
  • Fluorouracil cream

Using photodynamic therapy, medication is applied to the skin to damage the skin cells that are sensitive to light. Redness, swelling, or burning could take place during this treatment.

Cryotherapy can also be used for actinic keratosis.

Check your skin regularly for signs of damage.  If something does not appear right to you, or it is bothersome, schedule an appointment with your dermatologist.  Look for new growths on the skin, or moles that have changed in size or colors.  One should also check birthmarks, bumps and freckles.

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Ichthyosis (ick-thee-OH-sis) is a skin disease that causes extremely dry, thick, and scaly skin resembles fish scales.

These are a heterogeneous group of disorders with both inherited and acquired forms. these are the types
Ichthyosis Vulgaris- Most common type of icthyosis Lamellar Ichthyosis- Lamellar ichthyosis is characterized by dark, plate (armor)-like scale. Epidermolytic Hyperkeratosis- characterized by generalized redness and fine white scale Congenital Ichthyosiform Erythroderma- newborn infant with ichthyosis who presented at birth with collodion baby appearance. X-linked Ichthyosis- due to a defect in the enzyme steroid sulfatase, affects males with generalized scaling that usually begins soon after birth.

Ichthyosis Treatment

Several hours each day may need to be devoted the skin if ichthyosis is present in an individual. Daily, a person will need to take a shower or a bath. The skin should be exfoliated on a daily basis, and moisturised well. Moisturising ointments or creams may need to be prescribed by a dermatologist for the individual. Oral retinoids can be prescribed to reduce scaling. If a secondary infection occurs on the skin, oral antibiotics will need to be prescribed. Tips that will help keep the skin looking and feeling its best include applying a good quality lotion within 3 minutes of bathing. Apply to wet skin to keep moisture trapped into the skin. Products that contain lactic acid, alpha hydroxy acids and urea will help to keep skin not only moisturised but also exfoliated. Rubbing a wet pumice stone over crusty scales on the skin can help to remove them. Should there be scales on the scalp, brushing wet hair gently will aid in removing the scales.  

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