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Guilherme Mazui

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What is the Difference Between Actinic Keratosis and Bowen’s Disease?

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Actinic keratosis (AK) and Bowen's disease are both skin conditions related to sun damage, but they have distinct differences:

Actinic Keratosis:

  • AK is considered a pre-cancerous condition.
  • It is an intraepidermal squamous neoplasm of sun-damaged skin.
  • AK is also known as solar keratosis and can be found on areas with chronic sun exposure, such as the dorsum of the hands, face, and scalp.
  • The risk of progression to malignancy is low, and there is a high probability of spontaneous regression.
  • Treatment options for AK include topical creams, gels, or ointments (fluorouracil, tirbanibulin, imiquimod, or diclofenac), photodynamic therapy (PDT), laser surgery, or chemical peeling.

Bowen's Disease:

  • Bowen's disease is a very early form of squamous cell skin cancer.
  • It is also known as SCC in situ, meaning it is confined to the epidermis.
  • Bowen's disease presents as persistent, scaly, non-thickened macules or patches, often asymptomatic, and can be found in areas such as the lower legs in women.
  • The transition to invasive squamous cell carcinoma is reported in 5-10% of cases, with a higher risk in immunosuppressed patients.
  • Treatment options for Bowen's disease may include treatments similar to those for actinic keratosis, depending on the severity and location of the condition.

In summary, while both actinic keratosis and Bowen's disease are related to sun damage and have potential for malignant progression, they differ in their current classification and risk levels. AK is considered pre-cancerous, while Bowen's disease is a very early form of squamous cell skin cancer. Treatment options for both conditions may be similar but depend on the severity and specific characteristics of the condition.

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  • What is the Difference Between Actinic Keratosis and Bowen’s Disease?
  • Comparative Table: Actinic Keratosis vs Bowen’s Disease

    • Comparative Table: Actinic Keratosis vs Bowen’s Disease

    Here is a table comparing Actinic Keratosis (AK) and Bowen's Disease:

    Feature Actinic Keratosis (AK) Bowen's Disease (BD)
    Definition AKs are precursors on the continuum of carcinogenesis toward squamous cell carcinomas (SCCs), also known as solar keratosis. BD is an in-situ squamous cell carcinoma of the epidermis.
    Risk of Malignancy Each AK has a low risk of progression to malignancy and a high probability of spontaneous regression. BD has a higher risk of progression to invasive squamous cell carcinoma.
    Histopathology AKs may have several intraepidermal layers of atypical keratinocytes, even approaching full-thickness atypia. BD refers to an erythematous patch or plaque, characterized by in-situ keratinocyte atypia.
    Causes AKs are mainly caused by significant sun exposure and UV rays, which induce mutation of the tumor-suppressor gene P53. BD etiology is multifactorial, involving sun exposure, immunosuppression, and Human Papilloma Virus (HPV) infections.
    Clinical Presentation AKs appear as well-defined scaly patches on sun-exposed skin. BD lesions are slow-growing, non-pigmented reddish patches with irregular edges and a yellow or white crusting or scaling surface.
    Treatment Treatments for AKs include topical creams, photodynamic therapy, and cryotherapy. Treatments for BD include topical creams, photodynamic therapy, cryotherapy, and surgical excision.
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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.