There are many reviews and discussions in recent times, assessing new therapeutic methods for actinic keratosis. The focus here is on how to achieve effective treatment for preclinical and clinical lesions, with a significant degree of tolerance. Having mentioned this, certain important elements ought to be addressed during this endeavor. These include the necessity for treating keratosis, individuals needing such therapy and the whether or not destroying keratoses is sufficient treatment.
Many dermatologists still hold the views that actinic keratosis in particular either needs destruction done only, does not need any treatment, or that topical therapeutic methods utilized by some patients are not cost-effective means. A 1974 report on the subject has in fact acknowledged that Keratosis treatment is both under-reported and under-diagnosed.
To say the truth, there are not that many patients alarmed by keratosis. These are not thus very likely to check into clinics for routine examination and subsequent treatments. This is so especially, considering that the methods used can cause severe discomfort, or inflict tremendous amount of pain. There are many patients who are at risk of developing cancer due to keratosis, who show a great need for treatment. Majority of them suffer suppressed immunity in some way and this exposes them to further incidences of mutation, resulting in carcinogenesis. Together with this, there is an immunosuppressive effect created by photo-damage. This is because after years of unprotected solar exposure, a patient’s immune system may deteriorate severely. Such long term exposure precipitates defective wound repair, antigen processing and tumor surveillance also. These consequences all lead to dermatoheliosis, dyschromia and folliculitis, which manifest damage from UV radiation.
Since actinic keratoses only reflect effects of long-term exposure to the sun, they are akin to extensive pathogenesis that results in skin cancer. Viewing this keratosis as symptomatic of squamous cell carcinoma (SCC), might aid in achieving better management of keratosis. There is general inadequacy in treating this condition and medical management of keratosis should be comprehensive enough to account for the entire pathogenic system. Field therapy should aim at ultimately combating and destroying actinic keratoses that are hidden at the start of treatment. An aggressive kind of therapy ought also to be conducted, which targets restoration of immunity and control of photo-damage effects. Such pursuits involve maximizing wound healing and counteraction of reactive oxygen systems. To a greater degree, they should include restoration of antigen presentation and tumor surveillance. This arrests the actual disease signified by keratosis.
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