Dialogues and Debates in Dermatology (DDD 1) : Which is the best option? To treat ASAP vs wait & see = Dialogues and Debates in Dermatology (DDD 1) : Which is the best option? To treat ASAP vs wait & see

다국어 초록 (Multilingual Abstract)

Actinic keratosis (AK) is a precancerous lesion caused by chronic exposure to ultraviolet light. It is known to occur mainly in Caucasians but the incidence in Korea is known to increase as well. Not all AKs progress into squamous cell carcinoma (SCC) but approximately 90% of SCCs have contiguous AKs which is consistent with the perception that SCCs are preceded by AKs. A study found that up to 60% of SCCs arise directly from an AK and another study showed that 136 of 165 SCCs have close relationship to AKs. Of these SCCs, 26.7% were seen to have occurred directly from an existing AKlesion and 55.7% were closely situated to an AK lesion. How much of the AKs actually progress into invasive SCCs is not yet known with certainty but the range is known to be anywhere from 0.075% to 16% or even more. This means that the majority of AKs remain stable or they may even regress. A review found that annual rates of regression for a single AK to be 15% to 63% with recurrence rates of 15% to 53%. These clinical data are not conclusive and it is still impossible to predict which AK will progress into an invasive SCC and which will regress. This uncertainty has ignited much discussion regarding the best treatment approach for AKs, with some encouraging careful follow up and others claiming aggressive approach.