It could be actinic keratoses, which often remain stable or spontaneously regress, but there is a risk that they evolve into invasive tumors. They are usually the result of prolonged exposure to ultraviolet rays. In fact they are more likely in those who work outdoors
Who suffers from actinic keratosis has little dangerous pre-cancerous skin lesions, a consequence of prolonged exposure to ultraviolet rays, which can evolve into invasive carcinoma. For this reason, the attention of experts towards this pathology has grown in recent years, known since the end of the nineteenth century but long underestimated, included by the Ministry of Health among skin cancers since 2016.
More frequent after the age of 40
Keratosis generally occurs after the age of 40 with small lesions on the skin that can take on different shapes and colors (pink, red or brown), rough to the touch and covered with scales, with dimensions ranging from a few millimeters up to 6 centimeters in diameter – he explains Ketty Peris, President of the Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases (Sidemast) -. Sometimes they can itch, others be completely asymptomatic. Almost half of the patients have six or more lesions, located in areas exposed to sunlight like the face, the scalp, the arms and the back of the hands. Unpredictable disease progression, for this early diagnosis and timely treatment are essential. In fact, national and international guidelines recommend di always treat all actinic keratoses because it is impossible to know if and which ones will turn into invasive squamous cell carcinoma.
The cure
There are many therapeutic approaches available today, aimed at both single and multiple lesions. There are treatments aimed at eliminating individual lesions, such as ablative procedures that destroy tissue such as liquid nitrogen cryotherapy, laser therapy or surgical removal, indicated for thicker lesions or when histological confirmation is needed to rule out squamous cell carcinoma – he says Piergiacomo Calzavara Pinton, Director of Dermatology at the Civil Hospitals and Dermatological Clinic of the University of Brescia -. Generally yes for more in favor of treatments that act not only on the individual lesion, but also on the surrounding skin, thus preventing the onset of new lesions or relapses. These are creams or gels with different active ingredients that can be applied directly to the affected skin area. Recently then it was authorized by the Italian Medicines Agency (Aifa), therefore also available in our country, a new topical treatment effective on neoplastic and preneoplastic lesions, which has shown that it can exert a selective action on the disease without causing significant alterations to healthy skin – adds Calzavara Pinton -. 5-Fluorouracil 4% is a cream that is applied once a day in adults for at least four weeks and has shown great tolerability. An important fact is why only one in ten patients discontinued treatment due to the appearance of side effects. This new treatment demonstrated a 100% cure rate in 54% of patients and a 75% cure rate in 80% of cases. Furthermore, 45% of patients are still free from relapses after 12 months.
Over 400 thousand Italians
Actinic keratosis one of the most widespread and frequent dermatological diseases and, according to estimates, it interests beyond 400 thousand Italians: About 20% of people aged 50-60 and up to 40% of those over 70 have at least one injury. It is necessary to counteract the development of the lesions before the situation can worsen, for this we need treatments that act in a timely manner – underlines Giuseppe Argenziano, full professor and director of the Dermatological clinic of the University of Campania Luigi Vanvitelli in Naples -. Very important too prevention: those who work outdoors (such as bricklayers, farmers, fishermen and sailors) are more at risk, together with those who spend a lot of time in the sun for passion (for example, lovers of sailing, golf, skiing and surfing). In addition, they are more likely to develop actinic keratosis people most sensitive to UV radiation, that is, those with fair skin, red hair and freckles. Finally, there are other risk factors including some chronic inflammatory diseases or immunosuppressive conditions that can favor the development of actinic keratoses. Exposing yourself to UV rays carefully is a crucial point in preventing keratosis: The intensity and quantity of solar radiation absorbed play an important role – concludes Peris, director of Dermatology at the Gemelli Polyclinic in Rome -. The decisive cumulative effect. Tanned beds and lamps should be avoided, which are very dangerous for the health of our skin, and always protect yourself with adequate creams and clothing when exposed to the sun, throughout the year.
November 1, 2021 (change November 1, 2021 | 09:29)
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