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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
Rivista di Dermatologia e Malattie Sessualmente Trasmesse
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
Giornale Italiano di Dermatologia e Venereologia 2016 December;151(6):628-33
Risk of skin cancer development in 672 patients affected by actinic keratosis
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.