Letters to the Editor

Relation of Actinic Keratoses to Squamous or Basal Cell Carcinoma

 


FREE PREVIEW. AAFP members and paid subscribers: Log in to get free access. All others: Purchase online access.


FREE PREVIEW. Purchase online access to read the full version of this article.

Am Fam Physician. 2008 Nov 1;78(9):1.

Original Article: Treatment Options for Actinic Keratoses

Issue Date:September 1, 2007

Available at: http://www.aafp.org/afp/20070901/667.html

to the editor:The article about actinic keratoses is somewhat misleading. It leaves one with the impression that actinic keratoses most commonly evolves into squamous cell carcinoma. Actually, based on my personal experience during 45 years of practice, basal cell carcinoma is at least 10 times more likely to result from actinic keratoses of the face or ears (squamous cell carcinoma of the lower lip is almost always found in cigarette smokers).

Author disclosure: Nothing to disclose.

in reply:Basal cell carcinomas, squamous cell carcinomas, and actinic keratoses share common risk factors, such as age, sex, location of residency, occupation (indoor versus outdoor), and propensity to sunburn.1 Dr. Pentecost makes an excellent clinical point that an actinic keratosis lesion often overlies a basal carcinoma lesion.2,3

In addition, basal cell carcinomas are a far more common form of nonmelanoma skin cancer than squamous cell carcinomas (80 versus 19 percent, respectively). However, actinic keratosis lesions do not appear to be a precursor to basal cell carcinomas. In a study of 6,000 Australians, a preexisting actinic ker-atosis was a predictive factor for squamous cell carcinomas and basal cell carcinomas. Coexisting actinic keratosis lesions were found in all but one of the 38 patients with squamous cell carcinomas; however, coexisting actinic keratoses were found in 76 of the 124 persons with basal cell carcinomas. This demonstrates that basal cell carcinomas do not require a co-existing actinic keratosis lesion to develop.

Author disclosure: Nothing to disclose.

REFERENCES

1. Marks R, Rennie G, Selwood T. The relationship of basal cell carcinomas and squamous cell carcinomas to solar keratosis. Arch Dermatol. 1998;124(7):1039–1042.

2. Sambandan PG, Goldman GD. Infiltrative basal cell carcinomas presenting as actinic keratosis: implications for clinical practice. Dermatol Surg. 2008;34(1):9–13.

3. Jacobs RJ, Phillips G. Basal cell carcinoma mistaken for actinic keratosis. Clin Exp Optom. 2006;89(3):171–175.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.



 

Copyright © 2008 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


More in AFP


Editor's Collections


Related Content


MOST RECENT ISSUE


Jul 1, 2016

Access the latest issue of American Family Physician

Read the Issue


Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article