These are skin lesions due to the abnormal growth of skin cells, which are stimulated by prolonged exposure to ultraviolet rays. It is a typical clinical manifestation of photoageing, appearing more frequently after the age of 50 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 who have undergone organ transplants, genetic syndromes characterised 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 rough to the touch. They are usually reddish in colour and covered with flaking scales or crusts. They are usually smaller than 1 cm in diameter, although they may coalesce to form larger scaly red patches
They usually appear on areas of the skin with prolonged exposure to the sun, 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.
Diagnosis is clinical, by questioning and examination of the skin lesions. In some cases, confirmation by biopsy is required to differentiate it from other types of lesions or to assess whether it may have become malignant.
Treatment usually involves cryotherapy and/or creams or gels containing fluorouracil (5-FU), imiquimod, diclofenac or ingenol mebutate.
These treatments aim to destroy the affected area of the most superficial layer of the skin, the epidermis. Sometimes other localised 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 prevention, physical sun protection (hat, sunshades, etc.) or sunscreen is very important.
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