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Aktinisk keratos

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Definition:
Aktinisk keratos kännetecknas av proliferation av dysplastiska keratinocyter. De är begränsade till epidermis och induceras av UV-ljus.
Förekomst:
Ökande frekvens med stigande ålder och vanligare bland män. Prevalens på upp till 38 % bland ljushyade personer ≥50 år gamla, boende i norra Europa.
Symtom:
Lesioner på solexponerad hud, särskilt i ansiktet, på öronbrosket, handryggen eller skalpen. De flesta lesioner är asymtomatiska, men några ger klåda eller sveda.
Kliniska fynd:
Aktinisk keratos framträder vid inspektion och palpation som skrovliga, fjällande, ljusa till rödbruna papler och plack, storlek från en millimeter till flera centimeter. Ofta flera lesioner samtidigt. 
Diagnostik:
Diagnosen kan ofta ställas på typisk klinisk bild. Biopsi rekommenderas vid osäker klinisk diagnos.
Behandling:
Kryoterapi, fotodynamisk behandling (PDT) och/eller lokalbehandling med läkemedel har god effekt.

 

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  • Caroline Simberg Danell, ST-läkare, Hudkliniken, Södersjukhuset
  • Lena Wanger, överläkare, Hudkliniken, Södersjukhuset
  • Anna Nager, med dr och specialist i allmänmedicin, Karolinska institutet