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TWO SKIN CONDITIONS SHARE THE SAME NAME…BUT THE SIMILARITY ENDS THERE: Leading dermatologist Dr. Joshua Fox on critical differences between Actinic and Seborrheic Keratoses.

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TWO SKIN CONDITIONS SHARE THE SAME NAME…BUT THE SIMILARITY ENDS THERE: Leading dermatologist Dr. Joshua Fox on critical differences between Actinic and Seborrheic Keratoses.

New York, NY, May, 2007 – Merriam-Webster’s Medical Dictionary defines keratosis as “any disease of the skin marked by tough or calloused growths.” It’s this broad definition that allows Actinic Keratosis and Seborrheic Keratosis to share the same name, despite the vast differences in their causes, their potential seriousness, their treatment regimens and even their prognoses.

“While both conditions have several features in common including the growth of thick, raised bumps on the skin and are increased in the elderly and with commonality between Actinic Keratosis and Seborrheic Keratosis,” Joshua Fox, MD, founder of Advanced Dermatology and a spokesman for the American Academy of Dermatology. “Ironically, the Actinic Keratosis often looks innocuous enough, but it is now considered by some dermapathologists to be either a precancer for or an incipient squamous cell carcinoma – a serious skin cancer. While the Seborrheic Keratosis is a completely benign growth, it  may mimic or look similar to a melanoma – the deadliest skin cancers of all,” Dr. Fox adds. “It’s so important that patients understand the differences between these conditions, and that they know what to do when they suspect either one.”

Actinic Keratosis: The facts

Actinic Keratoses, called AK, usually appear on the skin as small, red, rough, scaly, raised bumps or patches. They were once thought of as a precancerous growth. However, numerous experts now believe that the AK particularly if hypertrophic is the earliest stage of squamous cell carcinoma – the second most serious skin cancer behind melanoma. In an article published in Clinics in Dermatology in 2004, researchers at Northwestern University School of Medicine confirm that AKs are indeed early cancers, and recommend speedy treatment to prevent them from developing into invasive squamous cell carcinoma.1

Dermatologists can remove Actinic Keratoses in a number of ways. Cryotherapy uses liquid nitrogen to freeze the growths and cause them to fall off, while topical agents such as the chemotherapy drug fluorouracil can destroy the growths. Laser therapy is often considered the least painful and most precise method of removing AKs, as local anesthesia is used to ensure the patient’s comfort and the laser can easily target only the growths themselves without harming surrounding tissue.

Fortunately, if one starts early in life then AKs are usually preventable, as the leading cause of this condition is sun exposure (hence their alternate name, Solar Keratosis). Dr. Fox advises the following three steps to minimize the risk of developing Actinic Keratoses:

  1. USE SUNSCREEN every day, particularly on areas of the skin that will be exposed to the sun, such as the neck, face and forearms. “Although the sun’s UV rays are strongest in summer, using sunscreen year-round is critical to skin health and can help reduce the signs of aging on the skin as well,” Dr. Fox notes.
  2. WEAR SUN-SMART CLOTHING to cover as much of the skin as possible, and shade the eyes and face with a hat. “While winter weather makes it easy to keep skin covered, dressing to stay cool and protected in the summer can be a challenge,” Dr. Fox says. “I recommend light-colored clothing that reflects the sun’s rays, and thinner fabrics for comfort.”
  3. STAY OUT OF THE SUN whenever possible. Seek shade or carry something with you in the form of a large umbrella, and schedule outdoor time before 10:00 a.m. and after 3:00 p.m., as between these hours the sun’s UVB rays are the strongest.

Seborrheic Keratosis: The facts

A Seborrheic Keratosis is a bit of a mystery, as no one knows what causes these waxy dark brown or black bumps to appear, usually around age 40, and often to multiply with age. They are not caused by sun exposure, and indeed they can develop anywhere on the body. They can appear as a single spot, as a cluster of spots or all over the body. They can be small, or large and disfiguring. They tend to run in families, but it is not uncommon for someone without a family history to develop them. Because they are benign, they do not require treatment unless they itch, bleed, become bothersome, inflamed or infected. The most common methods of SK removal include cryotherapy, curretage and/or electrocautery and laser.

Despite the disparity surrounding Seborrheic Keratosis, Dr. Fox points out, two facts are certain: “These are completely benign skin growths, and they to the novice eye be easily be mistaken for melanoma…and vice versa.” The danger, then, surrounding Seborrheic Keratosis is a misdiagnosis, particularly one that misidentifies a melanoma as an Seborrheic Keratosis.

“This leads to the most important advice for patients regarding their skin,” Dr. Fox concludes. “First, incorporating skin self-exams and a regular skin check-up by a board-certified dermatologist can ensure any new growths or changes to existing skin conditions are caught at their earliest stages. Of course, any skin changes or new growths should be evaluated immediately by a specialist. Lastly, patients should never hesitate to seek a second opinion when it comes to their skin health.

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