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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Emi DIKA 1, Pier A. FANTI 2, Cosimo MISCIALI 2, Sabina VACCARI 1, Giuliana CRISMAN 1, Alessia BARISANI 1, Carlotta BARALDI 1, Simone RIBERO 3, Annalisa PATRIZI 1
1 Section of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; 2 Laboratory of Dermatopathology, Section of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; 3 Department of Dermatology, University of Turin, Turin, Italy
BACKGROUND: Actinic keratoses (AKs) are the most common type of keratinocytic lesions worldwide. The skin areas affected by the so-called “field cancerization” harbor mutagenetic risks for the development of squamous cell carcinoma (SCC).
METHODS: We retrospectively investigated the histopathological reports and clinical charts of 672 patients affected by multiple AKs, presenting at least 5 years of follow-up. The frequency of non-melanoma skin cancers (NMSC, namely SCC and basal cell carcinoma [BCC]) and malignant melanomas (MMs) in patients affected by multiple AKs were analyzed.
RESULTS: More than 40% of patients with a previous diagnosis of multiple AKs developed an NMSC (SCC or BCC), or an MM, during a follow-up period of 5 to 11 years. The risk of developing another skin malignancy appeared to be higher in the age range between 61 and 80 years. The relative risk of developing a BCC and/or an MM in patients with a previous AK diagnosis was found to be 4.52.
CONCLUSIONS: The presence of multiple AKs and “field cancerization” seems to be associated with a high risk not only of NMSC such as SCC and BCC, but also of MM. An adequate follow-up is required in these groups of patients.