European Journal of Dermatology

, Volume 27, Issue 6, pp 599–608 | Cite as

Prevalence and risk factors of actinic keratosis in patients attending Italian dermatology clinics

  • Maria Concetta FargnoliEmail author
  • Gianfranco Altomare
  • Elisa Benati
  • Francesco Borgia
  • Paolo Broganelli
  • Anna Carbone
  • Sergio Chimenti
  • Sergio Donato
  • Giampiero Girolomoni
  • Giuseppe Micali
  • Erica Moggio
  • Aurora Parodi
  • Stefano Piaserico
  • Giuseppe Pistone
  • Concetta Potenza
  • Mario Puviani
  • Margherita Raucci
  • Sabina Vaccari
  • Stefano Veglio
  • Andrea Zanca
  • Ketty Peris
Clinical report



Actinic keratosis (AK) is a common keratinocyte intraepidermal neoplasia.


To assess AK prevalence and potential risk factors in patients attending Italian general dermatology clinics.

Materials & methods

This retrospective study was conducted on clinical data from consecutive white outpatients aged ≥30 years, attending 24 general dermatology clinics between December 2014 and February 2015. AK prevalence (entire population) and multivariate risk factor analysis (patients with current/previous AK and complete data) are presented.


AK prevalence in 7,284 patients was 27.4% (95% CI: 26.4-28.4%); 34.3% in men and 20.0% in women (p<0.001). Independent AK risk factors in 4,604 patients were: age (OR: 4.8 [95% CI: 3.5–6.5] for 46–60 years, increasing with older age to OR: 41.5 [95% CI: 29.5-58.2] for >70 years), history of other non-melanoma skin cancers (OR: 2.7 [2.2-3.3]), residence in southern Italy/Sardinia (OR: 2.6 [2.1-3.0]), working outdoors >6 hours/day (OR: 1.9 [1.4-2.4]), male gender (OR: 1.7 [1.4-2.0]), facial solar lentigos (OR: 1.6 [1.4-1.9]), light hair colour (OR: 1.5 [1.2-1.8]), prolonged outdoor recreational activities (OR: 1.4 [1.2-1.7]), light eye colour (OR: 1.3 [1.1-1.6]), skin type I/II (OR: 1.3 [1.1-1.6]), and alcohol consumption (OR: 1.2 [1.0-3.3]). BMI ≥25.0 (OR: 0.6 [0.5-0.7]), regular sunscreen use (OR: 0.7 [0.6-0.8]), and a lower level of education (OR: 0.8 [0.7-1.0]) were independent protective factors.


AK prevalence was high in Italian dermatology outpatients. We confirm several well-known AK risk factors and reveal possible novel risk and protective factors. Our results may inform on the design and implementation of AK screening and educational programmes.

Key words

actinic keratosis prevalence risk factors Italy 


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Copyright information

© JLE/Springer 2018

Authors and Affiliations

  • Maria Concetta Fargnoli
    • 1
    Email author
  • Gianfranco Altomare
    • 2
  • Elisa Benati
    • 3
  • Francesco Borgia
    • 4
  • Paolo Broganelli
    • 5
  • Anna Carbone
    • 6
  • Sergio Chimenti
    • 7
  • Sergio Donato
    • 8
  • Giampiero Girolomoni
    • 9
  • Giuseppe Micali
    • 10
  • Erica Moggio
    • 11
  • Aurora Parodi
    • 12
  • Stefano Piaserico
    • 13
  • Giuseppe Pistone
    • 14
  • Concetta Potenza
    • 15
  • Mario Puviani
    • 16
  • Margherita Raucci
    • 17
  • Sabina Vaccari
    • 18
  • Stefano Veglio
    • 19
  • Andrea Zanca
    • 20
  • Ketty Peris
    • 21
  1. 1.Department of DermatologyUniversity of L’AquilaL’AquilaItaly
  2. 2.Department of DermatologyUniversity of Milan IRCCS GaleazziMilanItaly
  3. 3.Department of DermatologyUniversity of Modena and Reggio EmiliaModenaItaly
  4. 4.Department of Clinical and Experimental Medicine, Section of DermatologyUniversity of MessinaMessinaItaly
  5. 5.Dermatologic UnitDepartment of Oncology, City of Health and Scienze of TurinTurinItaly
  6. 6.Department of Dermato-OncologySan Gallicano InstituteRomeItaly
  7. 7.Department of DermatologyUniversity of Tor VergataRomeItaly
  8. 8.DermatologyCrotone HospitalCrotoneItaly
  9. 9.Department of Medicine, Section of DermatologyUniversity of VeronaVeronaItaly
  10. 10.Department of DermatologyUniversity of CataniaCataniaItaly
  11. 11.Department of DermatologySpedali Civili di BresciaBresciaItaly
  12. 12.IRCCS AOU San Martino-IST, DiSSal Section of DermatologyUniversity of GenoaGenoaItaly
  13. 13.Dermatology Unit, Department of DermatologyUniversity of PadovaPadovaItaly
  14. 14.Department of DermatologyUniversity of PalermoPalermoItaly
  15. 15.Dermatology Unit, Department of Medical-Surgical Sciences, and BiotechnologiesSapienza University of Rome - Polo PontinoTerracinaItaly
  16. 16.Dermatology and Dermatologic Surgery UnitSassuolo HospitalSassuoloItaly
  17. 17.Dermatology and Skin Cancer UnitArcispedale Santa Maria Nuova-IRCCSReggio EmiliaItaly
  18. 18.Division of Dermatology, Department of Diagnostic, Experimental and Specialty MedicineUniversity of BolognaBolognaItaly
  19. 19.Department of DermatologyRegional Hospital of Aosta ValleyAostaItaly
  20. 20.Dermatology UnitCarlo Poma HospitalMantovaItaly
  21. 21.Department of DermatologyCatholic University of the Sacred HeartRomeItaly

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