Analysis of factors affecting the course of actinic keratosis

Abstract

Actinic keratosis (AK) is a photodependent skin impairment with local intraepidermal atypia of keratinocytes, which is manifested by erythematous, erythematous­squamous, papulo­squamous elements with localization mainly in open (for insolation) areas of the body. Objective — to analyze the comorbidity and factors affecting the course of АК in different age groups of the population, taking into account the growing incidence of AK in recent years, especially in the southern regions of Ukraine. Materials and methods. During 2020—2024 under our supervision were 78 patients with AK aged 40 to 83 years, of which 40 were men and 38 were women. Trigger factors and somatic diseases were analyzed, which, according to patients, could affect the course of dermatosis. Results and discussion. The average age of men under our supervision was (54.3 ± 0.3) years, women — (58.4 ± 0.5) years. 54 (69.2 %) patients had a complicated family history of AK, including 3 (3.8 %) people having first­line relatives suffering from malignant skin diseases. 56 (71.8 %) of the respondents identified their past sun exposure as excessive and accompanied by skin burns followed by epidermal detachment. 5 (6.4 %) patients had long­term contact with harmful substances (petroleum products, household chemicals). In the observation group, 45 (57.7 %) patients with nicotine dependence were found. Against the background of AK concomitant pathology was revealed: diseases of the cardiovascular system (coronary heart disease — in 23 (29.5 %) people, hypertension — in 14 (17.9 %)); diabetes mellitus — in 5 (6.4 %) people; autoimmune pathology (autoimmune thyroiditis — in 2 (2.6 %) people, Behçet’s disease — in 1 (1.3 %) woman, ulcerative colitis — in 1 (1.3 %) man); oncological processes of different localization — in 11 (14.1 %) patients from the observation group. Conclusions. As a result of the clinical study, it was established that one of the leading factors in the development of AK, in addition to excessive insolation, is genetic predisposition, the study of the mechanisms of which is an important aspect in the development of new methods for the treatment of dermatosis and prevention of neoplastic transformations; extended oncological screening of patients with AK is etiopathogenetically justified; an increase in the number of people with nicotine dependence in the group of patients with actinic keratosis (57.7 %) compared with the total number of the nicotine dependent in Ukraine (40—45 %) requires further study of the combined effect of excessive insolations and smoking on the development of AK.