Actinic Keratosis

Question: How long does it take a cancerous actinic keratosis to turn into cancer? 10% of actinic keratosis may be pre-cancerous. How long would it take one to turn into cancerous spot?

Answer: For the 10% that does become cancer, the time it takes depends on a lot of things. It depends on the individual, their general state of health (immunocompromised people can't fight off cancer as well as others), and the other things they might do to increase their chances of getting cancer in general (like smoking, not exercising, not eating the right foods, exposing their skin to too much sun, etc). There are actuarial tables that estimate mortality when you take some of these things into account. Also, treatment makes a big difference.

Question: Is it possible to get actinic keratosis on an area of skin that has had little to no sun damage? On my inner upper arm is a patch of dry scaly red skin about 10mm by 3mm. It's not itchy and has been there for months and creams don't make a difference. I was sunburnt when I was younger but only on my back and back of my arms. What else could it be if not actinic keratosis? Thanks

Answer: No.

Question: Does all cases of actinic keratosis develop to SCC? Should they all be removed by surgery?

Answer: Depending on the dermatologist that you talk to, generally speaking about one in (six or ) eight actinic keratosis will eventually progress to become a SCC. This process can often be reversed by regular use of a drug like Solaraze. http://www.bradpharm.com/products/Doak/p… Apply twice daily and over time most AKs will fade away. Those that do not will probably eventually need freezing or removing. Another drug option for actinic keratosis is Aldara. The good thing about Aldara is that it can also be used to treat early SCCs. Aldara is usually applied every other day. Inflammation occurs at the site of the AK or SCC. This continues for 2-4-6 weeks (depending on size of lesion) and then when no more inflammation occurs you quit treating the spot and the AK or SCC will slough off and the area will begin healing. If needed the treatment can be done a second time after a month of rest. It takes a little practice to figure out how to best use Aldara but this certainly beats having to have numerous skin lesions excised surgically. http://www.aldara.com/ Aldara is currently FDA approved for treating AKs and BCC and will soon be approved for treating superficial SCCs. These new immune modifying drugs are the new direction in dermatology for treating skin cancers and other previously difficult to treat skin issues. You should also realize that there is much debate in the dermatology community about using these drugs to treat AKs, BCC, and SCC because much of the income of dermatologists has been derived from removing these lesions surgically. Some older Drs refuse to do anything besides cut them out because using drug therapy can really cut into their income. Make sure your dermatologist is treating you as a person and not an income stream in whether or not he decides whether a skin lesion needs excising or can be treated with drug therapy. btw - Lesions treated with Aldara can look quite inflamed and not good at all after 4-6 weeks of treatment but if you wait another month or six weeks post treatment you will have no scar and won't even be able to tell where the lesion previously was located.

Question: what is bowenoid actinic keratosis and how does photo dynamic therapy work?

Answer: First add some grundge psybrine juice with a dash of seismologen dust and mix well, then add some griboidiate granules, which give off a pleasant aroma like a soft but delicate almond smell. Finally, put some hydrothermoid into the mix and agiatate for six minutes.

Question: Actinic Keratosis from head CT scans? Have you experience that? is that possible?

Answer: HB, Not likely. CT scans have drastically changed. That would be extremely rare. Nothing to worry about. Take a deep breath and enjoy yourself. Everything will be fine.

Question: Is actinic keratosis a real danger?

Answer: Its indeed a precancerosis, a lot of people have it, especially those who have been in the sun a lot in their lifes, its easily removed with a laser, so if you have some, you should best contact a dermatologist

Question: Removal of Actinic Keratosis (sun spots)? I had some sun spots frozen for removal, but one on my face was sort of big and they cut it away from the skin. Well I guess some of the skin had to be cut too and now I have a small indentation. Has anyone had this done and did the skin grow back? I plan on calling the dr. when the office reopens. Thanks.

Answer: Actinic Keratosis Actinic keratosis (also called solar keratosis, sun spots or AK) is a pre-cancerous condition of thick, scaly or crusty patches of skin (actinic – caused by sunlight; keratosis – thickened scaly growth). AK is common in fair-skinned people and caused by long-term sun exposure. AKs may progress to invasive squamous cell carcinomas (SCC) and are by far the most common lesion with malignant potential to arise on the skin. In the United States, AK represents the second most frequent reason for patients to visit a dermatologist. The frequency of AKs is directly related to sun exposure and skin type. AK can occur in patients as young as 20 or 30 years of age in areas of high sun exposure but is more common in patients aged 50 years and older. http://www.magenbiosciences.com/pages/ac…

Question: Is this actinic keratosis? Or something worse? A few days ago I found a small, scaly patch on my lower belly but didn't really worry about it. Then today I found another one on the backside of my arm, and upon a full body inspection I found one more (a tiny one) on my side. They don't itch or bother me really at all. I have never really sunbathed a lot or spent an excessive amount of time outdoors (no more than most kids anyway, and probably a little less) but I am fair skinned and burn easily which I know is a risk factor for skin cancer. Are there any medical professions or skin cancer patients/survivors who could take a look and this photo and tell me what you think? It's a little gross I know.. blargh I'm panicking :( http://i130.photobucket.com/albums/p274/…

Answer: If it is not an actinic keratosis then it is something worse. This bump is not a major health crisis but just a reminder to make an appointment soon with a dermatologist and get this lesion removed and biopsied. Some Drs think actinic keratosis is an early stage of squamous cell carcinoma while others think AK is a pre-cancer. In either case you need to get the worst spot removed and biopsied and probably get the lesser spots frozen with cryotherapy. You do look very fair skinned and you will probably need yearly derm appointments from now on.

Question: I have a round, slightly raised patch on my forehead? I am 62 and had a similar patch on my nose two years ago. It was Actinic keratosis. I had it frozen off. Now I have developed a patch slightly smaller than a 5p piece on my forehead. It is slightly darker than my skintone and has started to itch a lot. Any advice please? I am waiting to see the GP in two weeks' time.

Answer: This doesn't sound like actinic keratosis. I work around alot of people being a nurse and without seeing it I really can't tell you what it is, but with it itching, I'd say a ringworm or eczema or something to that effect. The only thing you can do is put anti fungal cream on ringworm and Eucerin cream works for eczema. Like I said, I could really tell you better if I could see it. Oh, by the way, if it's a ringworm, it will get bigger without treatment.

Question: Does Long hair on a male cause more skin damage to them? For instance: acne blackheads whiteheads Actinic Keratosis Acne (Pimples) Alopecia Areata Atopic Dermatitis Birthmarks and Other Abnormal Skin Pigmentation Boils Cellulite Chickenpox (Varicella) Exct.

Answer: Where did you get this list from? Acne and chicken-pox aren't even remotely related :\ Chicken-pox is a virus, it's not caused by skin irritation by long hair.

Question: which of the following neoplastic lesions originates in the dermis rather than in the epidermis? A. squamous cell carcinoma B. Actinic keratosis C. Dermatofibroma D. Seborrheic keratosis

Answer: I think it's C, based on the presentation of the lesion, but check your text book or ask a doctor, they'd know on the spot

Question: Was I prescribed the wrong medication? I sprained my ankle a week ago, and I got it checked out today. My doctor prescribed me an ointment to ease the pain. I just applied the ointment, only to read the tube and see "for the use of topical treatment of actinic keratosis"- which is thick, scaly, or crusty patches of skin when exposed to sun for too long. The ointment is Solaraze Gel 3%. I think I might have been prescribed the wrong ointment? Or am I wrong and does this gel actually help sprains?

Answer: It contains Diclofenac. It's a generic anti-inflammatory medication, quite good when dealing with joints. Basically what it does is reduce pain and swelling, and lower the inflammatory response, which is the source of the pain in a sprained ankle, and involved in actinic keratosis as well.

Question: A 60 year old farmer presents with multiple patches of discoloration on his face.? biopsy of lesional skin reveals actinic keratosis. which of the following terms best describes the response of the skin to chronic sunlight exposure? Atrophy dysplasia hypertrophy metaplasia

Answer: Look at your study notes and your textbook. This is not a cheating service. But because I'm so nice, I'll narrow your choices: it's not atrophy or hypertrophy.

Question: Kerotosis pilaris? Whats the difference between Keratosis Pilaris and actinic keratosis? i googled pictures of both and they look the same?

Answer: Keratosis pilaris is a benign, cosmetic skin condition where hair follicles are just simply "clogged", and KP usually doesn't occur on the face (although it can). Actinic keratosis is caused by sun-damage, which is not always benign, and is considered a pre-cursor to skin cancer, and medical treatment is usually recommended to prevent the transition to squamous cell carcinoma. AK frequently occurs on the face, unlike KP, although it can occur anywhere where there the skin has been exposed to sun and received sun damage. AK can cause tingling/prickly sensations; KP doesn't. Usually, only a dermatologist can differentiate one from the other if there is a question.

Question: do i have this? Actinic keratosis — This is a tiny bump that feels like sandpaper or a small, scaly patch of sun-damaged skin that has a pink, red, yellow or brownish tint. Unlike suntan markings or sunburns, an actinic keratosis does not usually go away unless it is frozen, chemically treated or removed by a doctor. An actinic keratosis develops in areas of skin that have undergone repeated or long-term exposure to the sun's UV light, and it is a warning sign of increased risk of skin cancer. About 10% to 15% of actinic keratoses eventually change into squamous cell cancers of the skin. http://i205.photobucket.com/albums/bb213… those two circles arent raised, but they do feel rough. is that what i have?

Answer: i have had many of them--they first appear as a small scaly slightly rough place. - easily treated with an ointment--i use "efudex"--they grow slowly but the sooner you treat them the better for you.---i go to dermatologist bout every 4 months just because of them but i am older

Question: Skin Cancer ? on tip of nose? Had small [ 1/4 " ] red [scaley with 2 tiny indentations] spot at tip of nose 5 yrs ago that was treated with Carac and it went away. Now it's back same size and appearance. Went to doctor 3 days ago, who said it was probably actinic keratosis and used the "freeze" tx. Said it would blister + peel. It has not. Just looks redder. Maybe the can was empty. lol He said if it persists, I will need a biopsy. How long do I wait? Wonder if I should request another "freeze" first?

Answer: When a skin lesion is frozen with cryosurgery, sometimes the blistering doesn't always happen and the skin dying and peeling will be gradual over the next few days. However, since this is a recurrence, you need to watch this area carefully. My guess is your Dr under treated the lesion because of the location. Excision and surgery on the tip of your nose is always more problematic in terms of healing and scarring compared to the results from cryosurgery (freezing) which usually causes little or no scarring. You can safely wait 30-60 days before returning to the Dr however if you have immediate regrowth of the original lesion, move this date up sooner. I'm guessing that eventually you will need to have this lesion excised. The main thing is to not ignore regrowth. What you describe is a small basal cell carcinoma which may take years to return if this freezing didn't get it. Most BCC grow very slowly but you don't want to ignore them because they can become unsightly to remove if they get big. http://www.nlm.nih.gov/medlineplus/ency/…

Question: Is this an early sign of skin cancer? I have a closely trimmed goatee and I recently noticed a football shaped bare spot in the mustache. It's like it came out of nowhere. It is whiter than the skin around it and looks kind of like a rash or scar. And the top edge is red. I had an actinic keratosis removed from my chin last year that had been caused by sun damage. I hope it's not a problem because my Cobra ran out and I'm having trouble getting health insurance. Can this be precancerous? And can it really pop up in the middle of facial hair?

Answer: My suggestion is trying to absorb as much information as you can before making up your mind,here    www.HealthInsuranceIdeas.info    is a good one.

Question: Is it a bad sign if there's still no pathological diagnosis on a skin biopsy after 2 weeks? Someone close to me had a skin lesion biopsied 2 weeks ago. On a follow up visit, her doctor claims there's still no definitive diagnosis and that the specimen was forwarded to yet another lab. If this were something innocuous like actinic keratosis, wouldn't a diagnosis have been rendered within a day or two? I'm starting to worry for her. Not stupid at all, Occulty. Hope is all I have to cling to right now. Thanks :) Thanks, Dr. Frog.

Answer: There are many types of skin lesions and many types of skin cancers. I have been treated for a few of them due to growing up in Hawaii. My doctor is one of the foremost skin cancer doctors in NYC and still his lab has trouble being certain what some of them are. It may be that it is too early for it to be diagnosed definitively. The vast majority of these lesions turn out to be non-metastatic skin caners or pre-cancerous lesions. They are generally quickly and easily treated.

Question: Anyone good with Medical Terminology? I need some help? I have to find misspelled words in this note: MEDICAL RECORD 1 University Hospital and MedicalCenter 4700 North Main Street Wellness, Arizona 54321 (987) 555-3210 PATIENT NAME: Sandra Wharton CASE NUMBER: 76548-INT DATE OF BIRTH: 10/03/xx DATE: 07/27/xx OPERATIVE REPORT CASE HISTORY: Mrs. Wharton is a 50-year-old white woman presenting to the dermatology clinic for follow-up of a nevus located at the medial aspect of her left eyebrow. Patient’s medical history is also significant for actinic keratosis, primarily of the scalp and ears, as well as chronic eczema, primarily of the forearms bilaterally. INDICATIONS FOR PROCEDURE: Comparing today’s exam with past medical records and photos from 10/20/xx, the nevus shows changes that include hair loss, “crusty” surface, and some enlargement of a lesion. The nevus has been present for approximately 3 years. Risks, benefits, indications and expectations were discussed with the patient regarding excision and biopsy, and she has agreed to proceed. PREOPERATIVE DIAGNOSIS: Displastic nevus, left eyebrow. ANESTHESIA: Xylocaine 1% with epinephrine. PROCEDURE: After written consent was obtained, the site was prepped and draped in the usual sterile fashion with betadine. The skin was incised at superior pole of the lesion. The lesion was then excised as diagnosed, including a margin of clinical normal dermis. Specimen was submitted to pathology. The superior pole was sutured. Hemostasis was achieved with electrocautery. Two A-T flaps were then constructed on superior aspect of upper left eyelid. Flaps and upper left eyelid undermined 2 to 3 mm. Flaps sutured with 6-0 Vicryl, followed by 6-0 nylon for closure. Pressure dressing was applied. Patient tolerated the procedure well. POSTOPERATIVE DIAGNOSIS: Biopsy revealed basal cell carcinoma, nodular, transected at base. and this note: MEDICAL RECORD 2 University Hospital and MedicalCenter 4700 North Main Street Wellness, Arizona 54321 (987) 555-3210 PATIENT NAME: William McBride CASE NUMBER: 10003-MKL DATE OF BIRTH: 12/04/xx DATE: 04/30/xx HISTORY REPORT: William McBride is a 55-year-old white man who complains of pain in both knees when walking and golfing. He states that his knees have “been painful” for many years since he quit playing semiprofessional hockey, but the pain has become much more severe in the last 6 months. He was admitted to the MedicalCenter’s Orthopedic Department for an arthroscopy of his left knee. PREOPERATIVE DIAGNOSIS: Degenerative arthritis of the left knee, with possible tear of the medial meniscus. OPERATIVE REPORT: After induction of spinal anasthetic, the patient was positioned on the operating table, and a tourniquet was applied over the upper left thigh. After positioning of the leg in a circumferential holder, the end of the table was flexed to allow the leg to hang freely. The patient’s left leg was prepped and draped in the usual manner. Following exsanguinations of the leg with an Esmarch bandage, the tourniquet was inflated to 33 mmHg. The knee was inspected using anterolateral and anteromedialparapatellar portholes. FINDINGS: The synovium in the suprapatellar pouch showed moderate to severe inflammatory changes with villi formation and hyperemia. The undersurface of the patella showed loss of normal articular cartilage on the lateral patellar facet with exposed bone in that area and moderate to severe chondromalacia of the medial facet. Similar changes were noted in the intercondylar groove. In the medial compartment, the patient had smooth articular cartilage on the femur and moderate chondromalacia of the tibial plateau. The medial meniscus appeared normal with no evidence of tears and a smooth articular surface on the femoral condyle. No additional pathology being identified. The tourniquet was then released and the knee flushed with lactated Ringer’s solution until the bleeding slowed. The wounds were Steri-stripped closed, a sterile bandage with an external Ace wrap was applied, and the patient was returned to the postoperative recovery area in stable condition. The patient tolerated the procedure well. POSTOEPRATIVE DIAGNOSIS: Degenerative arthritis with mild chondromalacia of the left knee. This class is kind of kicking my butt. I appreciate any help I can get!

Answer: strapadictame

Question: Can anyone help me comprehend this skin cancer diagnosis? It's my mom's. She is having removal surgery Friday morning. I don't understand lots of the words. Can anyone with deeper knowledge of skin cancer help me out? "Final Diagnosis Early Squamous Cell Carcinoma In Situ, arising in a Hyperplastic Actinic Keratosis on severely Sun-damaged Skin - RIGHT CHEEK" "Microscopic Description In this biopsy of sun-damaged skin, there is scanthosis with atypia of the lower two-thirds of the epithelium. The atypical keratinocytic hyperplasia extends down adnexal structures. In another focus, there is more prominent full thickness. The tumor extends to the lateral margins."

Answer: This is the second most common type of skin cancer. It rarely metastases. Your mom will probably undergo Mohs, which is the best treatment. Mohs is a skin sparing technique that will completely remove the skin cancer (margins are cleared before closure) and provide a cosmetically pleasing closure. Your mom will be fine, she should wear a sunscreen with SPF 30 or greater every day, and so should you. These cancers are caused by sun exposure.