Derm: Actinic Keratoses: Free MSRA Podcast

🎧 Actinic Keratoses – MSRA Deep Dive☀️ Precancerous sun damage? Don’t overlook it. This episode breaks down Actinic Keratoses (AKs) using your structured revision notes, with everything from pathophysiology to grading and management – perfect for MSRA prep.🧠 What You’ll Learn📌 DefinitionActinic keratoses (AKs) = precancerous skin lesions caused by chronic ultraviolet (UV) exposure. Often appear as rough, scaly patches on sun-exposed areas.🔍 Also called solar keratosis or senile keratosis.📌 Why It MattersAKs are early indicators of UV damage and may progress to squamous cell carcinoma (SCC).☀️ They’re a biological marker of long-term skin cancer risk.📌 Causes & Risk Factors• Chronic UV exposure (sun or tanning beds)• Fair skin (Fitzpatrick I–II)• Older age• History of sunburns• Living in sunny climates (e.g. Australia)• Immunosuppression (e.g. post-transplant, HIV)📌 PathophysiologyUV radiation → DNA mutations in epidermal keratinocytes → disrupted cell growth → dysplastic lesions.🦠 HPV may also contribute.📌 Clinical Features• Dry, scaly, “sandpaper-like” patches• Most common on face, scalp, ears, hands• May be red, pink, or brown• Often multiple lesions = “field change”• Graded: • Grade 1 = subtle, better felt than seen • Grade 2 = moderate, visible and rough • Grade 3 = thick, hyperkeratotic, SCC-like📌 Differential Diagnosis🧠 Be able to distinguish AKs from:• SCC – rapid growth, ulceration• BCC – slower growth, pearly edges• Seborrhoeic keratosis – greasy, “stuck-on”• Bowen’s disease – larger plaques• Amelanotic melanoma• Discoid lupus erythematosus📌 Investigations🔍 Usually clinical diagnosis🔬 Biopsy if:• Lesion is rapidly changing, thickened, ulcerated• Diagnosis uncertain• Rule out SCC📌 Management Options🎯 Treat all AKs due to potential malignancy.💊 Topical treatments for field change:• 5-Fluorouracil (5-FU)• Imiquimod• Diclofenac sodium💡 Warn patients: inflammation expected – redness, crusting = sign it's working!🧊 Procedural options for individual lesions:• Cryotherapy (liquid nitrogen)• Curettage ± cautery• Photodynamic therapy (PDT)• Surgical excision if thick/SCC risk📌 Patient Education• Emphasise sun protection – hats, sunscreen, clothing• Moisturise dry, sun-damaged skin• Encourage full-skin checks• Explain link between AKs and future skin cancer risk• Ongoing vigilance essential – lesions often recur📌 Prognosis & Complications• Some AKs regress spontaneously• BUT recurrence is common• ~10% progress to SCC over 10 years• Risk higher with red, thickened, elevated lesions• Presence of AKs = marker of chronic UV damage and higher future skin malignancy risk📚 Free MSRA Resources on Actinic Keratoses📝 Revision Notes:https://www.passthemsra.com/topic/actinic-keratoses-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/actinic-keratoses-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/actinic-keratoses-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/actinic-keratoses-rapid-quiz/🧪 Topic Quiz:https://www.passthemsra.com/quizzes/actinic-keratoses/🎓 Full Dermatology Course:https://www.passthemsra.com/courses/dermatology-for-the-msra/🎯 Tags#MSRA #MSRARevision #ActinicKeratoses #Dermatology #MSRAFlashcards #MSRAQuiz #MSRAQandA #PassTheMSRA #MSRADerm #SkinCancerPrevention #SunDamage #SCC #AKManagement #MSRALongCases #MSRA2025