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Rauhe, angegriffene Haut oder Präkanzerose?

Die Früherkennung der Aktinischen Keratose

Early detection of actinic keratoses

  • FORTBILDUNG . ÜBERSICHT
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MMW - Fortschritte der Medizin Aims and scope

Zusammenfassung

In hellhäutigen Populationen aller Kontinente werden in ansteigender Zahl Aktinische Keratosen, auch solare Keratosen genannt, festgestellt. Diese Hautveränderungen, die einer In-situ-Karzinombildung entsprechen, finden sich vorwiegend in einer chronisch dem UV-Licht exponierten Haut. Woran Sie diese Hautveränderungen erkennen können, erfahren Sie hier.

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Literatur

  1. Armstrong BK, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Photobiol B. 2001;63:8–18

    Article  CAS  PubMed  Google Scholar 

  2. Criscione VD, Weinstock MA, Naylor MF et al. Actinic keratoses natural history and risk of malignant transformation in the Veterans Affairs Tropical Tretinoin Chemoprevention Trial. Cancer. 2009;115:2523–30

    Article  PubMed  Google Scholar 

  3. de Rijke JM, Schouten LJ, Hillen HF et al. Cancer in the very elderly Dutch population. Cancer. 2000;89:1121–33

    Article  PubMed  Google Scholar 

  4. Diffey BL, Langtry JA. Skin cancer incidence and the ageing population. Br J Dermatol. 2005;153:679–80

    Article  CAS  PubMed  Google Scholar 

  5. Frost C, Williams G, Green A. High incidence and regression rates of solar keratoses in a queensland community. J Invest Dermatol. 2000;115:273–7

    Article  CAS  PubMed  Google Scholar 

  6. Holme SA, Malinovszky K, Roberts DL. Changing trends in nonmelanoma skin cancer in South Wales 1988-98. Br J Dermatol. 2000;143:1224–9

    Article  CAS  PubMed  Google Scholar 

  7. Lucas R, McMichael T, Smith W et al. Environmental Burden of Disease Series, No. 13. Solar Ultraviolet Radiation. Global Burden of Disease from Solar Ultraviolet Radiation. Geneva: World Health Organization, Public Health and the Environment, 2006

    Google Scholar 

  8. Salasche SJ. Epidemiology of actinic keratoses and squamous cell carcinoma. J Am Acad Dermatol. 2000;42:4–7

    Article  CAS  PubMed  Google Scholar 

  9. Memon AA, Tomenson JA, Bothwell J, Friedmann PS. Prevalence of solar damage and actinic keratosis in a Merseyside population. Br J Dermatol. 2000;142:1154–9

    Article  CAS  PubMed  Google Scholar 

  10. Heaphy MR Jr, Ackerman AB. The nature of solar keratosis: a critical review in historical perspective. J Am Acad Dermatol. 2000;43: 138–50

    Article  PubMed  Google Scholar 

  11. Stockfleth E, Sterry W, Carey-Yard M and Bichel J. Multicentre, open-label study using imiquimod 5% cream in one or two 4-week courses of treatment for multiple actinic keratoses on the head. Brit J Derm. 2007;157 (Suppl. 2):41–6

    Article  CAS  PubMed  Google Scholar 

  12. Schmitt J, Diepgen T, Bauer A. Occupational exposure to non-artificial UV-light and non-melanocytic skin cancer-a systematic review concerning a new occupational disease. J Deutsch Derm Gesell. 2010;8:250–64

    Article  Google Scholar 

  13. Schwartz RA, Bridges TM, Butani AK, Ehrlich A. Actinic keratosis: an occupational and environmental disorder. J Eur Acad Dermatol Venereol. 2008;22:606–15

    Article  CAS  PubMed  Google Scholar 

  14. Dodson JM, DeSpain J, Hewett JE, Clark DP. Malignant potential of actinic keratoses and the controversy over treatment. A patient-oriented perspective. Arch Dermatol. 1991;127:1029–31

    Article  CAS  PubMed  Google Scholar 

  15. Werner RN, Sammain A, Erdmann R et al. The natural history of actinic keratosis: a systematic review. Br J Dermatol. 2013;169:502–18

    Article  CAS  PubMed  Google Scholar 

  16. Pritchett EN, Doyle A, Shaver ChM, Miller B, Abdelmalek M, Cusack CA, Malat GE, Chung CH L. Non-melanoma skin cancer in nonwhite organ transplant recipients. JAMA Dermatology. 2016;152:1348–53

    Article  PubMed  Google Scholar 

  17. Ashton KJ, Weinstein SR, Maguire DJ, Griffiths LR. Chromosomal aberrations in squamous cell carcinoma and solar keratoses revealed by comparative genomic hybridization. Arch Dermatol. 2003;139:876–82

    Article  CAS  PubMed  Google Scholar 

  18. Sorg O, Tran C, Saurat JH. Cutaneous vitamins A and E in the context of ultraviolet- or chemically-induced oxidative stress. Skin Pharmacol Appl Skin Physiol. 2001;14:363–72

    Article  CAS  PubMed  Google Scholar 

  19. Wiswedel I, Keilhoff G, Dörner L, Navarro A, Böckelmann R, Bonnekoh B, Gardemann A, GOLLNICK H. UVB irradiation-induced impairment of keratinocytes and adaptive responses to oxidative stress. Free Radical Res. 2007;41:1017–27

    Article  CAS  Google Scholar 

  20. Biesalski H, Hemmes Ch, Hopfenmüller W, Schmid Ch, Gollnick H. Effects of controlled exposure of sunlight on plasma and skin levels of ß-carotene. Free Radic Res. 1996 24:215–24

    Article  CAS  PubMed  Google Scholar 

  21. Gollnick H, Hopfenmüller W, Hemmes Ch, Chun S, Schmid Ch, Sundermeier K, Biesalski H. Systemic beta carotene plus topical UV-sunscreen are an optimal protection against harmful effects of natural UV-sunlight: results of the Berlin-Eilath study. Eur J Dermatol. 1996;6:200–5

    Google Scholar 

  22. Jackson S, Storey A. E6 proteins from diverse cutaneous HPV types inhibit apoptosis in response to UV damage. Oncogene. 2000;19: 592–8

    Article  CAS  PubMed  Google Scholar 

  23. Stockfleth E, Meyer T, Benninghoff B, Salasche S, Papadopoulos L, Ulrich C, Christophers E. A randomized, double-blind, vehicle-controlled study to assess 5% imiquimod cream for the treatment of multiple actinic keratoses. Arch Dermatol 2002;138: 1498–50

    Article  CAS  PubMed  Google Scholar 

  24. McBride P, Neale R, Pandeya N, Green A. Sun-related factors, betapapillomavirus, and actinic keratoses: a prospective study. Arch Dermatol. 2007;143:862–8

    Article  PubMed  Google Scholar 

  25. Clydesdayle G, Dandle GW, Müller HK. Ultraviolet light induced injury: Immunological and inflammatory effects. Immunology and Cell Biology 2001;79:547–68

    Article  Google Scholar 

  26. Ambach A, Bonnekoh B, Gollnick H. UVA radiation induces suppression of perforin-granule release from CD8hi + cytotoxic T lymphocytes ex vivo. J Invest Dermatol. 2004;123:237–9

    Article  CAS  PubMed  Google Scholar 

  27. Schwarz Th. UV-induzierte regulatorische T-Zellen. JDDG. 2005;3:507–10

    Article  Google Scholar 

  28. Slaughter DP, Southwick HN, Smejkal W. Field cancerization in oral stratified squamous epithelium. Clinical implications of multicentric origin. Cancer. 1953;6:963–8

    Article  CAS  PubMed  Google Scholar 

  29. Braakhuis BJM, Tabor MP, Kummer JA, Leemans CR, Brakenhoff RH. A genetic explanation of Slaughter’s concept of field cancerization: Evidence and clinical implications. Cancer Res. 2003;63:1727–30

    CAS  PubMed  Google Scholar 

  30. Anwar J, Wrone DA, Kimyai-Asadi A, Alam M. The development of actinic keratosis into invasive squamous cell carcinoma: evidence and evolving classification schemes. Clin Dermatol. 2004;22:189–96

    Article  PubMed  Google Scholar 

  31. Fuchs A, Marmur E. The kinetics of skin cancer: progression of actinic keratosis to squamous cell carcinoma. Dermatol Surg. 2007;33:1099–101

    CAS  PubMed  Google Scholar 

  32. Guenthner ST, Hurwitz RM, Buckel LJ, Gray HR. Cutaneous squamous cell carcinomas consistently show histologic evidence of in situ changes: A clinicopathologic correlation. J Am Acad Dermatol 1999;41:443–8

    Article  CAS  PubMed  Google Scholar 

  33. Lober BA, Lober CW. Actinic keratosis is squamous cell carcinoma. South Med J. 2000;93:650–5

    Article  CAS  PubMed  Google Scholar 

  34. Peris K, Micantonio T, Piccolo D, Fargnoli MC. Dermoscopic features of actinic keratosis. J Dtsch Dermatol Ges. 2007;5:970–6

    Article  PubMed  Google Scholar 

  35. Zalaudek I, Kreusch J, Giacomel J, Ferrara G, Catricalà C, Argenziano G. How to diagnose nonpigmented skin tumors: a review of vascular structures seen with dermoscopy: part II. Nonmelanocytic skin tumors. J Am Acad Dermatol. 2010;63:377–86

    Article  PubMed  Google Scholar 

  36. Ulrich M, Maltusch A, Röwert-Huber J, González S, Sterry W, Stockfleth E, Astner S. Actinic keratoses: non-invasive diagnosis for field cancerisation. Br J Dermatol. 2007;156 (Suppl 3):13–7

    Article  PubMed  Google Scholar 

  37. Korde VR, Bonnema GT, Xu W, Krishnamurthy C, Ranger-Moore J, Saboda K, Slayton LD, Salasche SJ, Warneke JA, Alberts DS, Barton JK. Using optical coherence tomography to evaluate skin sun damage and precancer. Lasers Surg Med. 2007;39:687–95

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mogensen M, Jemec GB. Diagnosis of nonmelanoma skin cancer/keratinocyte carcinoma: a review of diagnostic accuracy of nonmelanoma skin cancer diagnostic tests and technologies. Dermatol Surg. 2007;33:1158–74

    CAS  PubMed  Google Scholar 

  39. Göppner D, Mechow N, Liebscher J, Thiel E, Seewald G, Buchholz A, Gollnick H, Philipp CM, Schönborn K-H. Hochauflösende Zwei-Photonen-Bildgebung von H&E-Schnitten in der Dermatohistopathologie: eine Pilotstudie an Hauttumoren. Photonics & Lasers in Medicine. 2012;1:133–40

    Article  Google Scholar 

  40. Yantsos VA, Conrad N, Zabawski E, Cockerell CJ. Incipient intraepidermal cutaneous squamous cell carcinoma: a proposal for reclassifying and grading solar (actinic) keratoses. Semin Cutan Med Surg. 1999;18:3–14

    Article  CAS  PubMed  Google Scholar 

  41. Kerl H, Garbe C, Cerroni L Wolff HH (Eds). Histopathologie der Haut. Springer Verlag 2001.

    Google Scholar 

  42. Ackerman AB. Solar keratosis is squamous cell carcinoma. Arch Dermatol 2003;139:1216–7

    Article  PubMed  Google Scholar 

  43. Glogau RG. The risk of progression to invasive disease. J Am Acad Dermatol. 2000;42:23–4

    Article  CAS  PubMed  Google Scholar 

  44. Schmitz L, Kahl P, Majores M, Bierhoff E, Stockfleth E, Dirschka T. Actinic keratosis: correlation between clinical and histological classification systems. JEADV 2016;30:1303-

    CAS  PubMed  Google Scholar 

  45. Quaedvlieg PJ, Tirsi E, Thissen MR, Krekels GA. Actinic keratosis: how to differentiate the good from the bad ones? Eur J Dermatol. 2006;16:335–9

    CAS  PubMed  Google Scholar 

  46. Röwert-Huber J, Patel MJ, Forschner T, Ulrich C, Eberle J, Kerl H, Sterry W, Stockfleth E. Actinic keratosis is an early in situ squamous cell carcinoma: a proposal for reclassification. Br J Dermatol. 2007;156(Suppl 3):8–12

    Article  PubMed  Google Scholar 

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Correspondence to Harald P. M. Gollnick.

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Der Autor erklärt, dass er sich bei der Erstellung des Beitrages von keinen wirtschaftlichen Interessen leiten ließen. Er legt folgende potenzielle Interessenkonflikte offen: keine.

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Gollnick, H.P.M. Die Früherkennung der Aktinischen Keratose. MMW - Fortschritte der Medizin 159 (Suppl 1), 57–63 (2017). https://doi.org/10.1007/s15006-017-9042-6

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  • DOI: https://doi.org/10.1007/s15006-017-9042-6

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