Longitudinal Assessment of the Prevalence of Actinic Keratosis and Extensive Risk Factor Evaluation: An Update from the Rotterdam Study

Abstract

Limited population-based studies are available to analyze the prevalence, risk factors, and longitudinal outlook of actinic keratoses (AK). These aforementioned features were assessed using Rotterdam Study participants aged 40 and older who underwent a full-body skin examination (FBSE) by a dermatology trained physician. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for the associations between risk factors and the presence of AK. Among 8,239 eligible participants, the prevalence of one or more AKs was 21.1% (95% CI: 20.2-22.0) and was higher in men. Male sex, age, lighter hair and eye color, baldness, genetic risk score (GRS), and digital photoaging measures (digitally-assessed pigmented spots, telangiectasias and global facial wrinkling) had a positive association with AK. Cigarette smokers had reduced odds of having AK, with current smokers having the lowest risk. Among patients with two AK assessments, there was no difference in the presence of AK during follow-up between treated and untreated participants. In conclusion, GRS and digital photoaging measures showed associations with increased lesion count. At the individual level, patients were most likely to decrease in AK severity group (i.e. with less AKs) over time, possibly regardless of whether or not participants were treated.