Hypertrophic actinic keratosis (AK), also known as hypertrophic solar keratosis, is a type of actinic keratosis. Actinic keratosis is a common precancerous skin condition that arises from prolonged exposure to ultraviolet (UV) radiation, typically from the sun or tanning beds. Hypertrophic actinic keratosis is a more advanced or severe form of actinic keratosis.
Causes:
The primary cause of hypertrophic actinic keratosis is cumulative sun exposure, which results in the accumulation of DNA damage in the skin cells. Other risk factors include:
- Fair skin: People with fair skin are more susceptible to the harmful effects of UV radiation.
- Age: AKs are more common in older individuals because they result from years of sun exposure.
- Geography: Living in regions with high levels of sunlight and UV radiation increases the risk.
- Immune suppression: Conditions or medications that weaken the immune system can increase the risk of AK development.
Appearance:
Hypertrophic actinic keratosis typically presents as a raised, rough, and scaly patch of skin. Its appearance may include the following characteristics:
- Thickening of the skin: Unlike flat actinic keratoses, hypertrophic AKs form raised, scaly, and sometimes warty or horn-like growths on the skin.
- Rough texture: The surface of the lesion can feel dry and rough, resembling sandpaper.
- Color changes: They are often reddish-brown, pink, or flesh-colored. The color can vary depending on the individual and the degree of sun damage.
- Size: They can range in size from a few millimeters to several centimeters in diameter.
Treatment:
Hypertrophic actinic keratosis should be treated because it has a higher risk of progressing to squamous cell carcinoma, a type of skin cancer. Several treatment options are available, including:
- Cryotherapy: Liquid nitrogen is applied to freeze and destroy the lesion. It causes the AK to peel off as it heals.
- Topical medications: Prescription creams or gels like 5-fluorouracil (5-FU), imiquimod, or diclofenac can be applied directly to the affected area to stimulate the body’s immune response and remove the AK.
- Photodynamic therapy (PDT): A photosensitizing agent is applied to the lesion, and then it is exposed to specific wavelengths of light to destroy the abnormal cells.
- Curettage and electrodesiccation: The dermatologist uses a curette to scrape off the lesion, followed by an electric needle (electrodesiccation) to destroy any remaining abnormal cells.
- Laser therapy: Lasers can be used to remove hypertrophic AKs, particularly if they are superficial and small.
- Surgical excision: For larger or thicker lesions, surgical removal may be necessary, and the tissue is sent for biopsy to ensure no cancer is present.
It’s important to consult with a dermatologist for an accurate diagnosis and to discuss the most appropriate treatment option for your specific case. Additionally, preventive measures such as sun protection (using sunscreen, wearing protective clothing, and avoiding peak sun exposure) can help reduce the risk of developing new actinic keratoses. Regular skin examinations are also essential, as early detection and treatment can prevent progression to skin cancer.
