Actinic ( Solar ) Keratosis : Management

Actinic keratosis (AK) is a common skin condition characterized by rough, scaly patches on sun-exposed areas. It is considered a precursor to squamous cell carcinoma (SCC) and requires appropriate management to prevent progression. The following table summarizes the referral management strategies for AK based on severity. Additionally, it outlines the various treatment agents and modalities used, along with their mechanisms of action.

Agents Used in the Management of Actinic Keratosis

1. Topical Fluorouracil 5% (Efudix):

   • Mechanism: Inhibits cell proliferation by interfering with DNA synthesis, leading to the death of rapidly dividing cells.
   • Application: Applied twice daily for 3-4 weeks.
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2. Actikerall (0.5% 5FU/10% Salicylic Acid Solution):

   • Mechanism: Combines a chemotherapeutic agent (fluorouracil) with a keratolytic (salicylic acid) to enhance penetration and treat thickened lesions.
   • Application: Applied once daily for 6-12 weeks.
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3. Imiquimod Cream:

   • Mechanism: Stimulates the immune system to produce cytokines, enhancing the body's ability to attack abnormal cells.
   • Application:
     • 5% cream: Applied three times a week for 4 weeks.
     • 3.75% cream: Applied daily for 2 weeks, repeated after a 2-week break.
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4. Diclofenac Sodium ( Solaraze )

   • Mechanism: Anti-inflammatory agent that reduces abnormal cell growth by inhibiting...