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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery

Written by Dr. Ringpfeil

Actinic Keratosis

Actinic Keratosis - Overview

Actinic keratosis is a precancerous growth on the skin. It begins 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, the risk is increased with a history of intense or life-long sun exposure, fair skin, or an impaired immune system.

Diagnosis

Actinic keratosis develops 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 keratosis can progress to squamous cell carcinoma. This is more likely to occur in men compared to women, 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 keratosis 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 health concerns or failure to respond to the most common type of treatment, shallow excision may be both diagnostic and curative.

Where actinic keratosis is multiple or confluent, at sites of poor healing or with poor response to standard therapies, photodynamic therapy, topical chemotherapy or immunotherapy 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 keratosis.

Treatment and Medication

Since it is not possible to predict which actinic keratosis will progress to skin cancer of the squamous cell type, preventative medicine mandates that actinic keratosis 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 the number of treatment sessions required. Fortunately, actinic keratosis is usually very responsive to treatment.

Coping

Important aspects of coping with actinic keratosis 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 lifestyle 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 removed with treatment, which eases fear about their progression to skin cancer.

Prevention

Actinic keratoses occur because of 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.

Patients should avoid tanning beds and tan-accelerating agents, perform self-examinations monthly, and report changes to their dermatologist. Schedule your yearly routine full-body skin evaluation. (You may need more frequent examinations if you are on immunosuppressive treatment.)

How can we help you?

SKIN

# of surveys: 4187
Last updated: 1/02/2024 11:10 AM

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%

Compare our service to other similar practices

excellent
87.9%
very good
10.1%
good
1.8%
poor
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very poor
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Overall doctor performance

excellent
94.2%
very good
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poor
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The doctor listened to you attentively

excellent
93.9%
very good
4.97%
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The doctor took time to answer your questions

excellent
94.0%
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The doctor explained treatment options

excellent
94.3%
very good
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good
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The doctor explained treatment options

excellent
92.0%
very good
5.69%
good
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poor
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Front desk performance

excellent
85.6%
very good
10.2%
good
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poor
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very poor
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Aesthetician performance

excellent
88.6%
very good
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Office comfort

excellent
90.9%
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Parking

excellent
66.4%
very good
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good
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Friendliness of the staff during appointment

excellent
90.9%
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What WE DID WELL

(Answers:674)

Yes, I liked Dr. Ringpfeil's attentive, friendly demeanor and the fact that she expained things well, making available every sort of treatment, but also making clear what was needed/recommended and what could/should be skipped in a sensible, conservative approach.

#12024-05-02

Very Professional and Friendly. Would definitely recommend to friends and family.

#22024-02-03

The doctor was extremely attentive, respectful and thorough. This was a very good visit overall.

#32023-08-22

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

#42024-03-28

Once in the examining room, I was treated professionally by both individuals whom I saw.

#52011-06-01 16:55:08

The staff was very friendly, helpful and professional. The doctor herself is a pro, I was very impressed and will definitely recommend her to others, especially of my race. Its very hard to find a good dermatologist and I believe she is wonderful and really knows what she's doing. I am glad that I came here, thank you.

#62011-11-10 12:40:32

There is an open, respectful friendliness about the practise.

#72024-06-02

Doctor was incredibly well spoken and informative.

#82023-06-22

This was an emergency appointment, and you all took wonderful care of me!!! Thanks so much!

#92023-09-14

I liked how they wanted to know about past experiences and history and seemed to take that into account and also thought outside the box. Very personable, friendly, yet right to the point.

#102024-05-31

What can we do better?

(answers:373)

music mix

#12023-07-10

Just don't change what you're doing

#22024-03-07

How about a smile to greet a brand new patient? How about explaining that I need to go and fill out info on the computer instead of pointing over there you need to complete things. I felt like walking out by the rudeness. The medical assistant and phys asst were extremely kind, thorough and helpful. I realized that I was here to seek help for my child and received amazing medical help. Thank you.

#32011-07-11 11:52:49

I was dissapointed when my appointment was cancelled because of the snow. I had to wait 6 weeks to get another appointment. I wish that I could have been worked in sooner.

#42011-03-11 14:29:03

No major suggestions. I got all the answers I needed.

#52024-01-28

I was very happy with the care I received.

#62010-09-14 10:44:00

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

it was a little warm in the waiting area

#82023-11-25

The entire visit was just perfect so I had no suggestions at this time.

#92010-10-05 12:14:11

This was my first visit and although i was uncomfortable with my problem which was addressing I was truly happy with everything else.

#102011-07-28 15:11:23

Customer Rating : 4.6

Based on 537 ratings
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