NEW YORK (Reuters Health) - In patients with multiple actinic keratoses (AKs), Olson grade III and the need for more treatment were identified as markers for increased risk of cutaneous squamous cell carcinoma (cSCC) in a secondary analysis of a randomized trial.
"There is an alarming increase in sun damage resulting in AK and cSCC," Dr. Shima Ahmady of Maastricht University Medical Center in the Netherlands told Reuters Health by email. "In a population-based cohort study in the Netherlands, AK affected 49% of men and 28% of women aged 50 years and older."
"We found that the risk of invasive cSCC was significantly higher in patients with Olsen grade III AK (AK with severe keratosis) compared to AK with mild keratosis," she noted. "In patients with Olsen grade III AK who needed additional treatment, more than a third developed an invasive cSCC within four years. Close follow-up of these patients is therefore indicated."
By contrast, she said, "Because the risk of cSCC was very low in patients with AK Olsen grade 1, follow-up might be omitted, and further studies should be aimed at investigating whether treatment is still indicated in those patients."
As reported in JAMA Dermatology, Dr. Ahmady and colleagues conducted a secondary analysis of a multicenter randomized clinical trial in the Netherlands involving 624 patients (median age, 73; 90%, men) with a minimum of five AKs within an area of 25 cm2 to 100 cm2 on the head.
