They are skin lesions due to the abnormal growth of skin cells, which are stimulated to develop as a consequence of prolonged exposure to ultraviolet rays. It is a typical clinical manifestation of photoaging, appearing more frequently after 50 years of age and in people with fair skin.
It is caused by continuous exposure to UV rays from sunlight. There are factors that increase the risk of these lesions appearing, such as patients undergoing organ transplants, genetic syndromes characterized by alterations in DNA repair mechanisms, and certain toxins or drugs such as hydroxyurea and arsenic.
It manifests as flat or slightly raised spots (macules or papules), typically scratchy to the touch. They usually have a reddish tone and are covered by scales or crusts that flake off. They are usually smaller than 1 cm in diameter, although they may coalesce to form larger-scaling red plaques.
They generally appear on areas of the skin with prolonged sun exposure, such as the face, scalp, back of the hands, cleavage area and legs in women. When it appears on the lips, it is called actinic cheilitis.
The diagnosis is clinical, by interrogation and examination of the lesions on the skin. In some cases, confirmation by biopsy is required to differentiate it from other types of lesions or to assess whether it could have malignized.
Treatment usually includes cryotherapy and/or creams or gels with fluorouracil (5-FU), imiquimod, diclofenac or ingenol mebutate. These treatments seek to destroy the affected area of the most superficial layer of the skin, the epidermis. Sometimes other localized treatments (photodynamic therapy, laser surgery, chemical peel) or surgical removal are also used.
It is considered an early form of non-melanoma skin cancer; approximately 10% of cases may develop into a malignant form of skin cancer. For its prevention, physical sun protection (hat, sunshades, etc.) or sunscreen is very important.
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