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Aktinisk keratose

Sist revidert:
Sist revidert av:

Definisjon:
Benigne hudsvulster som utvikles i solskadet hud.
Forekomst:
Økende forekomst med grad av soleksponering og økende alder. Forekomst i Nord-Europa er ca. 11-30% blant voksne/eldre.
Symptomer:
Typisk en symptomfri fargeforandring eller utvekst i huden på soleksponerte områder.
Funn:
Kan ses eller kjennes som ru ujevnhet i huden, størrelse fra 1 mm til flere cm. Oftest lys-brune eller røde, skjellende elementer.
Diagnostikk:
Diagnosen stilles ved typisk utseende, ev. vevsprøve ved tvil
Behandling:
Behandles effektivt med kryokirurgi, fotodynamisk behandling eller lokalbehandling med medikamenter.
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  2. de Berker D, McGregor JM, Mohd Mustapa MF et al. British Association of Dermatologists' guidelines for the care of patients with actinic keratosis 2017. Br J Dermatol. 2017 Jan;176(1):20-43. PMID: 28098380 PubMed  
  3. Flohil SC, van der Leest RJ, Dowlatshahi EA, et al. Prevalence of actinic keratosis and its risk factors in the general population: the Rotterdam Study. J Invest Dermatol 2013; 133: 1971. pmid:23510990 PubMed  
  4. Del Regno L, Catapano S, Di Stefani A et al. A Review of Existing Therapies for Actinic Keratosis: Current Status and Future Directions. Am J Clin Dermatol. 2022 Feb 19. Epub ahead of print. PMID: 35182332.
  5. Padilla RS, Sebastian S, Jiang Z, et al. Gene expression patterns of normal human skin, actinic keratosis, and squamous cell carcinoma: a spectrum of disease progression. Arch Dermatol 2010; 146: 288. pmid:20231500 PubMed  
  6. Fernandez Figueras MT. From actinic keratosis to squamous cell carcinoma: pathophysiology revisited. J Eur Acad Dermatol Venereol. 2017 Mar;31 Suppl 2:5-7. PMID: 28263020 PubMed  
  7. Padilla RS, Robinson JK, Corona R. Epidemiology, natural history, and diagnosis of actinic keratosis. UpToDate; last reviewed Mar 2022. Accessed Apr 2022. www.uptodate.com  
  8. Steeb T, Wessely A, Petzold A, et al. Long-term recurrence rates of actinic keratosis: a systematic review and pooled analysis of randomized controlled trials published online ahead of print, 2021 Apr 16. J Am Acad Dermatol. 2021;S0190-9622(21)00815-X. PMID: 33872716 PubMed  
  9. Gupta AK, Paquet M, Vilanueva E, Brintnell W. Interventions for actinic keratoses. Cochrane Database of Systematic Reviews 2012; 12: CD004415. doi:10.1002/14651858.CD004415.pub2 DOI  
  10. Steeb T, Wessely A, Petzold A, et al. Evaluation of Long-term Clearance Rates of Interventions for Actinic Keratosis A Systematic Review and Network Meta-analysis. JAMA Dermatology 2021. pmid:34347015 PubMed  
  11. Jansen MHE, Kessels JPHM, Nelemans PJ et al. Randomized Trial of Four Treatment Approaches for Actinic Keratosis. N Engl J Med 2019; 380: 935-46. pmid:30855743 PubMed  
  12. Wolf JE Jr, Talyor JR, Tschen E, Kang S. Topical 3.0% diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses. Int J Dermatol 2001; 40: 709-13. PubMed  
  13. Thai KE, Fergin P, Freeman M, Vinciullo C, Francis D, Spelman L, et al. A prospective study of the use of cryosurgery for the treatment of actinic keratoses. Int J Dermatol 2004; 43: 687-92. PubMed  
  14. Patel G, Armstrong AW, Eisen DB. Efficacy of photodynamic therapy vs other interventions in randomized clinical trials for the treatment of actinic keratoses: a systematic review and meta-analysis. JAMA Dermatol. 2014 Dec. 150(12):1281-8.
  15. Zane C1, Facchinetti E, Rossi MT, et al.Cryotherapy is preferable to ablative CO2 laser for the treatment of isolated actinic keratoses of the face and scalp: a randomised clinical trial. Br J Dermatol. 2014 Jan 28. doi: 10.1111/bjd.12847. DOI  
  16. Madani S, Marwaha S, Dusendang JR, et al. Ten-Year Follow-up of Persons With Sun-Damaged Skin Associated With Subsequent Development of Cutaneous Squamous Cell Carcinoma. JAMA Dermatol. Published online March 24, 2021. PMID: 33760003.
  • Silje Folven Barlindhaug, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Morten Dalaker, avtalespesialist i hudsykdommer, Trondheim Hudlegesenter, Carl Johans gt 3, 7010 Trondheim
  • Sylvi Torvund, spesialist i allmennmedisin, Nidarvold legesenter, Trondheim