title: The value of the histopathologic examination in the diagnosis and management of the actinic keratosis.
abstract: Actinic keratosis, considered lately as an intraepithelial squamous cell carcinoma in evolution, are powerful predictors of the risk for developing a cutaneous carcinoma and melanoma. The aims of the study were to establish the value of the histopathologic examination as a confirmation method for the actinic keratosis diagnosis, to assess the percentage of these lesions that suffer a malignant transformation, and also the frequency of the association between actinic keratosis and cutaneous carcinomas. This is a retrospective study, performed on 208 patients diagnosed with different types of cutaneous precancers, hospitalized in Dermatology Clinic of Craiova, Romania, between 2006 and 2010. Actinic keratosis represented 37.93% (79 cases) of all cutaneous precancers (the most frequent cutaneous precancer). Patient's age ranged from 17 to 85 years, 54.8% of the patients being from rural environment; 86.07% of the lesions were located on the solar exposed skin (head and face). 72.16% of the actinic keratosis was clinical subdiagnosed. The most frequent form was hypertrophic actinic keratosis (89.06%); in 18.98% of cases, malignant transformation in squamous cell carcinoma was noticed. Actinic keratosis represent 86% of the precancers that associate a carcinoma, basal cell carcinoma being diagnosed the most frequent. In conclusion, actinic keratosis are the most frequent cutaneous precancer, diagnosed in chronic sun-exposed patients, and manifest a tendency to progress into a squamous cell carcinoma without a proper treatment. Pathologic evaluation is mandatory to an accurate assessment of the actinic keratosis prevalence, and for the right management of these lesions.
authors.affiliation: Dermatology Clinic, Emergency County Hospital, Craiova, Romania. alina.vilcea@yahoo.com
authors.forename: Alina Maria
authors.initials: AM
authors.lastname: Vîlcea
authors.forename: I D
authors.initials: ID
authors.lastname: Vîlcea
authors.forename: Claudia Valentina
authors.initials: CV
authors.lastname: Georgescu
authors.forename: V
authors.initials: V
authors.lastname: Pătraşcu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D055815:Young Adult