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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery

Written by Dr. Ringpfeil

Actinic Keratosis

Actinic Keratosis - Overview

An actinic keratosis is a precancerous growth on the skin. It initiates in the epidermis, the skin's exposed layer. Normally, epidermal cells develop in a precise, controlled and systematic fashion. Healthy new cells nudge older cells toward the skin's surface to die, and form a protective layer that continually regenerates and sheds. UV-radiation damages and changes the skin's texture and color, causing blotchiness or growths, including actinic keratoses and skin cancers. Although anybody can develop actinic keratoses, risk is increased with a history of intense or life-long sun exposure, fair skin or an impaired immune system.

Diagnosis

Actinic keratoses develop in sun-exposed areas. A single or several lesions may be present. The signs and symptoms of an actinic keratosis include a rough or scaly, flat to slightly raised bump that ranges in color from red to brown. Intermittent itching, burning or tenderness in the affected area can occur. Actinic keratoses are readily diagnosed upon professional evaluation. Rarely, further testing is needed, such as a skin biopsy, where a small sample is collected and sent for microscopic analysis.

Management

A subset of actinic keratoses can progress to squamous cell carcinoma. This is more likely to occur in men compared to woman, with advanced age, when multiple lesions have formed or with immune suppression. The exact rate is unknown and therefore, treatment is preferred over observation. Most actinic keratoses can readily be managed with local treatment alone. The therapy is chosen with consideration to the specifics of the site, number and individual needs. In case of diagnostic concern or failure to respond to first-line treatment, shallow excision may be both diagnostic and curative. Where actinic keratoses are multiple or confluent, at sites of poor healing or with poor response to standard therapies, photodynamic therapy, topical chemotherapy or immune therapy may be necessary. Long-term follow up with your dermatologist for the associated increased risk of non-melanoma skin cancer is recommended as is the avoidance of further sun exposure in an area that has developed actinic keratoses.

Treatment and Medication

Since it is not possible to predict which actinic keratoses will progress to a frank skin cancer of the squamous cell type, preventative medicine mandates that actinic keratoses be treated. Your doctor will discuss appropriate treatment for your individual lesions. Treatment options for actinic keratoses include cryosurgery, curettage, excision, chemical peel, creams that contain either anti-cancer medicines or stimulate your immune system to fight the pre-cancer, photodynamic therapy, CO2 laser ablation or dermabrasion. Each procedure has advantages and disadvantages, including discomfort, risk of scarring, duration of treatment and number of treatment sessions required. Fortunately, actinic keratoses are usually very responsive to treatment.

Coping

Important aspects of coping with actinic keratoses relate to recommended modifications in sun exposure during leisure or outdoor work, a changed appearance, seriousness of the diagnosis, control of the disease, and the sense of illness. While life style changes are easy to implement, they require discipline and constant awareness. Most of the time, a changed appearance from the original growth(s) or the treatment thereof does not require any cover up or scar revision treatments. Most actinic keratoses are easily eradicated with treatment, which eases fear about their progression to skin cancer.

Prevention

Actinic keratoses occur because of cumulative sun damage that is not sufficiently repaired by our immune surveillance. In addition to limiting your time in the sun, sun protective clothing, such as a hat with a wide brim or densely woven shirts or pants, as well as application and reapplication of sunscreens with UVA and UVB filters are appropriate measures when outdoors or traveling by car. Avoid tanning beds and tan-accelerating agents. Perform self examinations monthly and report changes to your dermatologist. Schedule your yearly routine full body skin evaluation. (You may need more frequent examinations if you are on immuno-suppressive treatment.)

How can we help you?

SKIN

# of surveys: 3853
Last updated: 2/11/2021 4:23 PM

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
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maybe
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not likely
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no
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Compare our service to other similar practices

excellent
87.9%
very good
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good
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poor
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Overall doctor performance

excellent
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The doctor listened to you attentively

excellent
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The doctor took time to answer your questions

excellent
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The doctor explained treatment options

excellent
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The doctor explained treatment options

excellent
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Front desk performance

excellent
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Aesthetician performance

excellent
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Office comfort

excellent
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Parking

excellent
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Friendliness of the staff during appointment

excellent
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What WE DID WELL

(Answers:674)

I like the doctor and how careful and thorough she is.

#12020-06-21

Everything was great!

#22020-06-16

Everything

#32020-04-23

I really liked how personable the doctor was during my appointment. She really made me fee confident about her ability.

#42020-10-18

I have been to a number of derm docs....often it seems as though they have you try this or that but never seem to have a clear plan as to how they will treat ALL of the issues at hand. Thank you for taking the time to address each one of my concerns.

#52020-04-18

Dr. Ringpfiel was very attentive; she explained very clearly different treatments and their outcomes and gave me some alternatives I could choose from. I was extremely pleased by the Dr's professionalism, excellence, kindness and attention. Definitely one of the best services I have received! I am bringing my son in 3 weeks!

#62020-11-25

The entire visit was a calming and pleasurable experience. The Dr. was superb. She was knowledgeable, attentive and genuinely listened. Jill is very personalble. The staff was very friendly. Melissa was really great. Truly the best experience that I have had in a Dr's office.

#72010-11-08 14:00:01

All was excellent

#82011-05-03 10:51:30

Doctor was incredibly well spoken and informative.

#92021-02-08

The visit went smoothly, and the physician answered my questions directly.

#102020-04-29

What can we do better?

(answers:373)

I have a suggestion: I noticed that two of the lovely rugs pose hazards to patients using walkers or who may have other mobility issues. The large rug placed at an angle and the narrow rug placed in front of the reception desk leave no room for these individuals to safely manuveur around the reception area and are likely to contribute to fall risks. I would suggest leaving these areas clear.

#12010-10-04 12:14:56

more availability for appointments.

#22020-11-20

Can't imagine any better first impression.

#32011-02-24 14:49:37

Nothing, my visit was great.

#42020-03-03

nothing just keep up the good work.

#52020-11-13

Service was excellent!

#62010-09-30 13:09:12

You often have a long wait time in the room for the doctor. When she does come in it is not for a very long time.

#72010-08-23 17:00:56

watercooler in waiting room.

#82020-04-08

excellent service

#92021-01-02

Keeping me from dying of skin cancer would be good (I will behave and do the checks and annual exam to help out!!!)

#102010-11-29 11:47:11
Customer Rating : 4.5

Based on 178 ratings
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