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level: Level 1 of Chapter 14 : Keratoses

Questions and Answers List

level questions: Level 1 of Chapter 14 : Keratoses

QuestionAnswer
What is keratoses?• Although actinic keratosis is not a skin cancer, it is considered to be precancerous • If these lesions are not treated, they can develop into squamous cell carcinomas • People with actinic keratosis are more likely to develop other types of skin cancer such as basal cell carcinoma and melanoma • So we have to treat all actinic keratoses, since it is impossible to know which ones will turn into skin cancer
How is clinical presentation of keratoses?• Actinic keratoses are in the form of reddish patches, rough and scaly • These lesions appear in places exposed to the sun, such as the face, ears, bald scalp, back of the hands, forearms and legs • Most patients have more than one, and stains can sting or burn. Some actinic keratoses appear on the lower lip
What are risk factors for keratoses?• Light-skinned people who often have freckles and burn quickly are most at risk • The over 40s who have been exposed to the sun are also at a greater risk of actinic keratosis, as are people who work outside because of their intense exposure to the sun • Too much exposure to the sun for many years eventually halts the development of keratinocytes in the outer layers of the epidermis • UV rays from the sun damage the skin's DNA, which causes this abnormal cell growth (dysplasia)
How is tx of keratoses?• Cryotherapy: This involves freezing the lesion with liquid nitrogen • There are also various creams that destroy precancerous cells: imiquimod, 5 FU • Surgery should be used to remove the lesion or to take a biopsy to see if it has developed into skin cancer • There are also other treatments by area, including various modalities of light treatment such as dynamic phototherapy (PDT) • Indication according to the number of lesions, their location, the age and the general state
How is prevention from keratoses?• Protect the skin from the sun • Regular use of sunscreen, even in cloudy weather, can help prevent the onset of actinic keratoses • Avoid using tanning beds or other similar devices: the lamps used in these devices emit ultraviolet rays that may be more intense than the sun's rays • Other sun protection methods are important: looking for shade and wearing a wide-brimmed hat, sunglasses and protective clothing • Patients with signs of skin damage caused by the sun (deep wrinkles, aging) or who have already had actinic keratosis should be monitored regularly to see if new lesions appear