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Clinicopathological Study of Actinic Keratoses in Korea


BACKGROUND: Actinic keratosis is one of the most common precancerous lesions, and its incidence in Western society has been reported to be up to 40%. However, few clinical and histopathologcial studies of actinic keratosis have been conducted in Korea. OBJECTIVE: The purpose of this study was to investigate clinical and histopathological features of actinic keratosis in Koreans. METHODS: We reviewed the medical records and biopsy specimens of 63 cases previously diagnosed as actinic keratosis at St.Vincents hospital of Catholic Medical Center from January 1999 to June 2003. RESULTS: We were able to compile clinical data and histologic information on 63 cases of actinic keratosis 1. The mean age at diagnosis was 72.6 years, and all the patients were over 50 years old. Actinic kerotosis developed predominantly in females at the sex ratio of 1: 3.8. 2. The disease duration was more than 1 year in 69.8% of patients, and there were few associated cutaneous malignancies, except two basal cell carcinoma. 3. Half of the patients was asymptomatic, however, 34.9% and 15.9% of the patients complained of pruritus and pain, respectively. The lesions were usually solitary, less than 1cm, and erythematous. 4. Actinic keratosis was involved mostly in face, especially cheek, forehead, chin, and nose by decreasing order. 5. Histopathologically, hypertrophic type was noted in 30.2% of the cases, atrophic type in 44.4%, bowenoid type in 19.0%, acantholytic type in 3.2%, and pigmented type in 3.2%. The histopathological scores according to subtype were 5.00(1.76) in hypertrophic type, 3.54(1.82) in atrophic type, and 6.83(1.03) in Bowenoid type. 6. The most common treatment modality was cryotherapy with liquid nitrogen, and surgical resection, electrodessication, and CO2 Laser were also used for the treatment of actinic keratosis. The recurrence was observed in one patient treated by cryotherapy and two patients by electodessication. CONCLUSION: Actinic keratosis in Koreans was precancerous lesion usually present on the face of female patients over 50 years old. Various histopathologic types including hypertrophic, atrophic, Bowenoid, acantholytic and pigmented type were noted, and the most common type was atrophic type. Actinic keratosis could be treated by cryotherapy with liquid nitrogen, surgical resection, eletrodessication and CO2 laser. However, because of the possibility of recurrence, close follow-up is needed.

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