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Die aktinische Keratose

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Zusammenfassung

Die aktinische Keratose (AK) ist definiert als Proliferation zytologisch atypischer Keratinozyten im Bereich der epidermodermalen Junktionszone in chronisch lichtgeschädigter Haut. Auf der nördlichen Hemisphäre liegt die Prävalenz von AK bei 11–25% der über 40-Jährigen. Die wesentliche Ursache für das Auftreten von AK ist die chronische Exposition gegenüber UVB-Licht (280–320 nm). Dadurch kommt es zu Mutationen des Telomerasegens und des Tumorsuppressorgens TP 53, das man in gleichem Maße auch bei invasiven spinozellulären Karzinomen (SSC) findet. Das Risiko der Ausbildung eines SSC aus AK innerhalb von 10 Jahren wird mit bis zu 16% angegeben. Histologisch lassen sich AK lediglich aufgrund der noch fehlenden Invasivität von SCC abgrenzen. Vor diesem Hintergrund und aufgrund der hohen Inzidenz der Erkrankung ist die begriffliche Neudefinition, beispielsweise als initiales spinozelluläres Karzinom, Gegenstand aktueller Diskussion. In der folgenden Übersicht werden aktuelle Aspekte zur Pathogenese und Therapie dargestellt.

Abstract

Actinic keratoses are defined as proliferation of cytologically atypical keratinocytes in the zone of epidermal-dermal junction in photodamaged skin. In the northern hemisphere the prevalence of actinic keratoses ranges depending on different epidemiological studies from 11% to 25% for people aged 40 or older. The main cause of actinic keratoses is exposure to UVB radiation in sunlight. UVB radiation induces mutations in the telomerase gene and in the tumor suppressor gene p53, which can also be detected in invasive squamous cell carcinoma. The only histological parameter to distinguish between actinic keratoses and SCC is the level of invasiveness. The risk for actinic keratoses to develop into SCC is about 16% over 10 years. For this reason and because of the high prevalence of actinic keratoses, it has been suggested to replace the term "actinic keratosis" with "intraepidermal squamous cell carcinoma" to better characterize the lesion. In the following review recent aspects of pathogenesis and therapy of actinic keratoses are discussed.

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Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie, Klinikum der Universität Regensburg

    P. Babilas, M. Landthaler &  R.-M. Szeimies

  2. Klinik und Poliklinik für Dermatologie, Universitätsklinik Regensburg, Franz-Josef-Strauß-Allee 11, 93042 , Regensburg

    R.-M. Szeimies

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  1. P. Babilas
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  2. M. Landthaler
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  3. R.-M. Szeimies
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Correspondence to R.-M. Szeimies.

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Babilas, P., Landthaler, M. & Szeimies, RM. Die aktinische Keratose. Hautarzt 54, 551–562 (2003). https://doi.org/10.1007/s00105-003-0543-0

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