Actinic keratosis is also called solar keratosis. This disease corresponds to a set of skin damage caused by excessive exposure to UV rays from the sun or artificial. Most patients do not develop a single keratosis but several keratoses.

The development of actinic keratoses requires strict dermatological monitoring. This pathology is considered to be pro-carcinogenic, ie which often leads to the development of skin cancers, in particular squamous cell carcinoma.

An early and regular visit to the dermatologist can check the extent of actinic keratosis and prevent the development of carcinoma. In case the cancer cells are already developing, it can be treated with effective treatments. (1)

The development of actinic keratoses results in the appearance of scaly patches: fragments of the skin that are seen to disappear. This skin damage can be pinkish, red or brown in color and can vary in size (from a few millimeters to a few centimeters).

The parts of the body that are most often exposed to the sun are generally the parts that are most often damaged:

– the face, especially the nose and forehead;

– the forearms and backs of the hands;

– ears ;

– the scalp in bald people;

– legs.

Visible stains are usually harmless in themselves and can sometimes be benign. However, in some cases, they can be painful, unsightly and itchy.

In view of this type of clinical manifestation, it is recommended to consult the general practitioner or a dermatologist as soon as possible in order to take charge of the disease as soon as possible and thus avoid any development of cancer.

Actinic keratosis concerns more people with fair skin, blue eyes, redheads, people with many freckles and people sensitive to sunburn. As well as people living and working in sunny countries or places.

In addition, a male predominance has been demonstrated in the context of this pathology.

Actinic keratosis generally develops several years after prolonged exposure to the sun and particularly affects people over 40 years of age. (2)

When atypical symptoms of actinic keratosis are observed, a consultation with a general practitioner or a dermatologist must be effective as soon as possible in order to avoid any risk of cancer development, in particular squamous cell carcinoma.

Many people who develop the disease have no symptoms. Only skin changes (spots, redness, burns, etc.) may be visible. In cases of symptomatic development, these clinical manifestations include:

– a feeling of roughness on the surface of the skin;

– the development of rough spots;

– itching and burning of the skin;

– dry lips.

Actinic keratosis is characterized by symptomatic appearances and disappearances. Symptoms may appear for several months, then improve or even disappear. After the rough appearance of the skin, characteristic of keratosis, it can become smooth again in a few days or weeks. Furthermore, clinical manifestations generally reappear after re-exposure to the sun.

Even in the event that the symptoms do not reappear, it is necessary to consult a dermatologist. Indeed, the development of scaly is effective when the top layer of the skin is largely damaged. In this sense, the development of skin cancer may appear, even if the clinical manifestations do not return. (1)

The origin of actinic keratosis is frequent and prolonged exposure to UV rays from the sun or artificial ones (during UV tanning).

Ultraviolet (UV) rays are therefore the cause of the development of this pathology. Most people repeatedly and intensively exposed to the sun have clinical manifestations associated with actinic keratosis.

When these UV rays reach the surface of the skin, they can cause more or less damage to the epidermis (upper layer of the skin). In young people, the body has the ability to repair some of this damage. However, over time, this damage accumulates and gets worse and the body is no longer able to repair it. Actinic keratoses or even skin cancer then develop. (1)

The risk factors for developing the disease affect people:

– fair-skinned;

– blondes or redheads;

– with blue, green or azure eyes;

– sensitive to sunburn;

– over 40 years of age;

– whose immune system is weakened;

– living and / or working in hot and sunny places;

– working with substances containing Polycyclic Aromatic Hydrocarbons (PAHs), found in coal or in tar. This category of people includes roofers in particular.

The diagnosis of the disease is first of all differential and is made by the observation of scaly skin on the skin by the general practitioner or by the dermatologist.

In some cases, this first diagnosis must be confirmed by taking a sample of the skin and examining it under a microscope.

A visit to the dermatologist is necessary if: (2)

– the general practitioner is not sure of the diagnosis;

– the general practitioner thinks that one or more of the tasks may be the cause of cancer;

– the tasks are particularly severe and extensive;

– the subject is on immunosuppressants;

– the symptoms do not subside after treatment.

The goal of treating the disease is to destroy actinic keratoses. Some patients therefore receive more than a single treatment. These therapeutic means include:

– cryotherapy: destruction of scaly membranes by cold;

– a chemical peeling of the scaly membranes;

– curettage, to clean the surface of the skin by scratching;

– dynamic photo therapy: using blue light or a bright laser, the light activates a solution to destroy keratoses;

– laser resurfacing, which is defined by peeling of the skin thanks to the action of a laser.

Medicines can also be prescribed in the treatment of the disease, they are: (1)

– a cream based on 5 -fluorouracil;

– a diclofenac sodium gel;

– an imiquimod cream;

– of an ingenol mebutate gel.