ActinicKeratosesNet Spotlight Article
Early Diagnosis and Treatment for AKs Can Make a Difference

Patients who have a specific medical condition may be invited to speak about their experiences at a scientific conference. The following story was told during a conference about actinic keratoses (AKs). To protect this patient’s privacy, his name does not appear.

In the early 1960s, a man visited his dermatologist for a rash. The man described this rash as occurring “all over his head.” The doctor prescribed a topical chemotherapy agent called 5-Fluorouracil (5-FU). This medication is effective in treating multiple AKs, and today, it is one of the most frequently used treatments for AKs in the United States. However, after using 5-FU twice daily for two weeks, the man stopped.

During an appointment with a dermatologist in 1994, the man said his dermatologist examined “a little something on my nose.” The dermatologist said, “I don’t like that,” and removed the lesion. The biopsy report revealed that the “little something” was squamous cell carcinoma, a type of skin cancer. A week later, the cancerous lesion had grown back.

Since then, this patient has endured more than 14 surgeries and extensive radiation therapy. After radiation therapy on his neck and head, this patient says he has felt “debilitated and beat up ever since.”

This man’s story illustrates the importance of early diagnosis and treatment for AKs. AKs have the potential to progress to squamous cell carcinoma, a type of skin cancer that can spread. By the time this squamous cell carcinoma was biopsied, it had grown, according to the Mohs surgeon who treated him, “right down to the bone.”

With early treatment, the cure rate for AKs often exceeds 90%. Today several treatment options, which have been approved by the U.S. Food and Drug Administration (FDA), are available. These include cryosurgery (freezing), a cream that stimulates the patient’s own immune system to destroy the lesions, surgical removal, and laser therapy. Most procedures can be safely and effectively performed in a dermatologist’s office.

Some treatment options require the patient to apply a topical medication at home. If your dermatologist prescribes a topical treatment that causes too much discomfort, be sure let your dermatologist know. The amount and/or times that you apply the medication often can be changed to make the treatment tolerable.

If you spot a new growth or notice a change to an existing lesion, be sure to contact a dermatologist. Even if you cannot see a lesion but can feel a patch of dry, rough, scaly skin, be sure to see a dermatologist. AKs often can be felt before they are seen. The man who spoke about his experiences at the conference recalls the “little something” on his nose began as “a little rough spot just below the bridge of my nose.”