Two Skin Conditions Share the Same Name, but the Similarity Ends There: Leading Dermatologist Dr. Joshua Fox on Critical Differences Between Actinic and Seborrheic Keratoses
Actinic Keratosis and Seborrheic Keratosis share the same name, despite the vast differences in their causes, their potential seriousness, their treatment regimens and even their prognoses.
New York, NY (PRWEB) May 6, 2007 -- Merriam-Webster's Medical Dictionary defines keratosis as "any disease of the skin marked by tough or calloused growths." It's this broad definition that allows Actinic Keratosis and Seborrheic Keratosis to share the same name, despite the vast differences in their causes, their potential seriousness, their treatment regimens and even their prognoses.
"Both conditions do have several features in common, including the growth of thick, raised bumps on the skin, and the increased incidence of both as we age," explains Joshua Fox, MD, founder of Advanced Dermatology and a spokesman for the American Academy of Dermatology. "Ironically, the Actinic Keratosis often looks innocuous enough, but it is now considered by some dermapathologists to be either a pre-cancer or the beginning stage of a serious skin cancer called squamous cell carcinoma," he adds. "And, while the Seborrheic Keratosis is a completely benign growth, it may mimic or look similar to a melanoma - the deadliest skin cancer of all," Dr. Fox adds. "It's so important that patients understand the differences between these conditions, and that they know what to do when they suspect either one."
Actinic Keratosis: The facts
Actinic Keratoses, called AK, usually appear on the skin as small, red, rough, scaly, raised bumps or patches. They were once thought of as a precancerous growth. However, numerous experts now believe that large Actinic Keratoses are the earliest stage of squamous cell carcinoma - the second most serious skin cancer behind melanoma. In an article published in Clinics in Dermatology in 2004, researchers at Northwestern University School of Medicine confirm that AKs are indeed early cancers, and recommend speedy treatment to prevent them from developing into invasive squamous cell carcinoma.1
Dermatologists can remove Actinic Keratoses in a number of ways. Cryotherapy uses liquid nitrogen to freeze the growths and cause them to fall off, while topical agents such as the chemotherapy drug fluorouracil can destroy the growths. Laser therapy is often considered the least painful and most precise method of removing AKs, as local anesthesia is used to ensure the patient's comfort and the laser can easily target only the growths themselves without harming surrounding tissue.
Fortunately, if one starts early in life then AKs are usually preventable, as the leading cause of this condition is sun exposure (hence their alternate name, Solar Keratosis). Dr. Fox advises the following three steps to minimize the risk of developing Actinic Keratoses:
- Use Sunscreen every day, particularly on areas of the skin that will be exposed to the sun, such as the neck, face and forearms. "Although the sun's UV rays are strongest in summer, using sunscreen year-round is critical to skin health and can help reduce the signs of aging on the skin as well," Dr. Fox notes.
- Wear Sun-Smart clothing to cover as much of the skin as possible, and shade the eyes and face with a hat. "While winter weather makes it easy to keep skin covered, dressing to stay cool and protected in the summer can be a challenge," Dr. Fox says. "I recommend light-colored clothing that reflects the sun's rays, and thinner fabrics for comfort."
- Stay out of the sun whenever possible. Seek shade or carry something with you in the form of a large umbrella, and schedule outdoor time before 10:00 a.m. and after 3:00 p.m., as between these hours the sun's UVB rays are the strongest.
Seborrheic Keratosis: The facts
A Seborrheic Keratosis is a bit of a mystery, as no one knows what causes these waxy dark brown or black bumps to appear, usually around age 40, and often to multiply with age. They are not caused by sun exposure, and indeed they can develop anywhere on the body. They can appear as a single spot, as a cluster of spots or all over the body. They can be small, or large and disfiguring. They tend to run in families, but it is not uncommon for someone without a family history to develop them. Because they are benign, they do not require treatment unless they itch, bleed, become bothersome, inflamed or infected. The most common methods of SK removal include cryotherapy, curretage and/or electrocautery and laser.
Despite the disparity surrounding Seborrheic Keratosis, Dr. Fox points out, two facts are certain: "These are completely benign skin growths, and to the novice eye, they can be easily be mistaken for melanoma…and vice versa." The danger, then, surrounding Seborrheic Keratosis is a misdiagnosis, particularly one that misidentifies a melanoma as an Seborrheic Keratosis.
"This leads to the most important advice for patients regarding their skin," Dr. Fox concludes. "First, incorporating skin self-exams and a regular skin check-up by a board-certified dermatologist can ensure any new growths or changes to existing skin conditions are caught at their earliest stages. Of course, any skin changes or new growths should be evaluated immediately by a specialist. Lastly, patients should never hesitate to seek a second opinion when it comes to their skin health."
1. Clin Dermatol. 2004 May-Jun;22(3):189-96
Bio: Joshua L. Fox, M.D., F.A.A.D
Joshua L. Fox, M.D., is a leading authority in the field of dermatology with an expertise in skin cancer, cosmetic surgery, and laser procedures. As an official spokesperson for the American Academy of Dermatology and the American Society for Dermatologic Surgery, Dr. Fox has been an expert resource on dermatologic topics for numerous televisions networks, including ABC, CBS, CNN, NBC and Telemundo, talk shows, radio stations, newspapers and magazines. He has received multiple research and clinical awards, including recognition from Top Doctors, Who's Who, Journal of Dermatologic Surgery and Oncology, Community Service Award from the American Society for Dermatologic Surgery, the prestigious Husic Award, as well as certificates of recognition for service from multiple hospitals, civic, educational and community organizations. Dr. Fox has authored and presented papers of his research on lasers, cosmetic procedures, stretch marks, scars, skin cancer, bug bites, photosensitivity and various rashes.
As founder and director of Advanced Dermatology and The Center for Laser and Cosmetic Surgery, Dr. Fox and associates have expanded the practice to one of the largest in dermatology, laser and cosmetic surgery, with more lasers than any hospital on the eastern coast. Dr. Fox is a graduate of the New York University Medical Center of Skin and Cancer and has been on the advisory board of the Psoriasis Foundation and National Rosacea Foundation, among others. He has also been a fellow of many societies, including the International Academy of Cosmetic Surgery, International Academy of Cosmetic Dermatology and the Society for Investigative Dermatology. Dr. Fox is the founder of the AAD Melanoma/Skin Cancer Prevention Program in Queens, New York (since 1987). Dr. Fox has been Chief of Dermatology of several major teaching hospitals, including Mt. Sinai Hospital of Queens and Jamaica Medical Center, and is currently on the staff of eight NY area hospitals. Dr,. Fox is also the founder of New Age Skin Research Foundation at www.newageresearch.org, committed to research and advocacy in dermatology. Dr. Fox and Advanced Dermatology and The Center for Laser & Cosmetic Surgery have been used as a resource center educating dermatologists, laser surgeons and cosmetic surgeons and others about lasers, cancer and cosmetic surgery. www.advancedd.com.
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