YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==KERATOSES, ACTINIC== 1 AUTHOR Schwartz RA TITLE Premalignant keratinocytic neoplasms. SOURCE J Am Acad Dermatol; VOL 35, ISS 2 Pt 1, 1996, P223-42 (REF: 399) ABSTRACT Premalignant keratinocytic keratoses are common, especially in pale-complected persons in whom they appear most often as an actinic keratosis. Although the actinic keratosis has a very low malignant potential, arsenic, tar, thermal, scar, reactional, and radiation keratoses may be more clinically aggressive. This article discusses these premalignant keratinocytic neoplasms. 2 AUTHOR Sober AJ AUTHOR Burstein JM TITLE Precursors to skin cancer. SOURCE Cancer; VOL 75, ISS 2 Suppl, 1995, P645-50 (REF: 40) ABSTRACT Certain cutaneous lesions serve as both precursors of skin cancer and markers for increased risk. The solar or actinic keratosis serves such a role for the nonmelanoma (NMSC) forms of skin cancer (basal cell carcinoma and squamous cell carcinoma). Clinically, these keratoses manifest as rough, scaly, erythematous patches on chronically sun-exposed surfaces. Conversion to squamous cell carcinoma in an individual lesion is uncommon and has been estimated at 1 per 1000 per year. Individuals with actinic keratoses have had sufficient chronic photodamage to produce skin cancer, and regular surveillance is recommended. The second precursor for invasive NMSC is Bowen's disease (squamous cell carcinoma in situ). Invasion of the dermis results in frank squamous cell carcinoma. Some types of viral warts may develop into squamous cell carcinoma. The most important precursor/marker for melanoma is the clinically atypical mole (CAM) or dysplastic nevus. CAMs occur in 5-10% of the U.S. population. CAMs, under photographic follow-up, have been observed to evolve into cutaneous melanoma. The frequency of conversion to melanoma of any single CAM is quite low; however, in melanoma-prone families, prospectively diagnosed melanomas arise in association with a histopathologically observed dysplastic nevus in more than 80% of the cases. Giant congenital melanocytic nevi have an approximately 6% lifetime risk of melanoma development. The risk associated with small congenital nevi is uncertain. Lentigo maligna develop into invasive melanoma with a frequency reported in the literature ranging from 5-50%. 3 AUTHOR Frost CA AUTHOR Green AC TITLE Epidemiology of solar keratoses. SOURCE Br J Dermatol; VOL 131, ISS 4, 1994, P455-64 (REF: 83) ABSTRACT Solar keratoses (SKs) or actinic keratoses are common dysplastic epidermal lesions which occur in pale-skinned individuals who are chronically exposed to intense sunlight. Together with basal cell carcinomas and squamous cell carcinomas, they constitute a major public health problem in such individuals. Reported SK prevalence rates range from 11 to 25% in various northern hemisphere populations, and amongst Australian adults the range is from 40 to 60%. In the only study to date reporting SK incidence data, 60% of subjects aged 40 years and over with SKs at baseline developed new lesions during 12 months of follow-up, compared with only 19% of those who were lesion-free on the first examination. Because existing epidemiological data on SKs are sparse, very little is known of their natural history, their role in carcinogenesis, or their preventability. In this review, current knowledge about the aetiology, diagnosis, and occurrence of SKs is discussed, as is the need for prospective studies in unselected communities. With accurate baseline data, public health authorities should be in a better position to determine the best preventive strategies, and to evaluate the effectiveness of these programmes. 8 AUTHOR Nicol NH TITLE Actinic keratosis: preventable and treatable like other precancerous and cancerous skin lesions. SOURCE Plast Surg Nurs; VOL 9, ISS 2, 1989, P49-55 (REF: 17) ABSTRACT Actinic keratosis, like many other precancerous and cancerous skin lesions are preventable and treatable. Nurses, physicians, other health care providers, school teachers, daycare workers, grandparents, parents, and children must assume the role of educating others regarding attitudes and knowledge about sun damage to the skin. Protecting one's skin should be a lifelong process from the newborn period onward. However, if sun damage does occur, the next important step is early detection of skin cancer. Individuals with associated risk factors should be screened routinely by health care personnel with expertise in the area of skin cancer. The best treatment of actinic keratosis, as with most diseases, is prevention.