CVderm - German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Eur Acad Dermatol Venereol. 2014 Mar;28(3):309-13. doi: 10.1111/jdv.12102. Epub 2013 Jan 24.
In Europe, only few and inconsistent data on the prevalence and treatment of actinic keratoses (AK) are available.
To determine the prevalence of AK in Germany, to identify potential predictors and to estimate the number of AK cases treated in dermatological practices.
In a multiple-source approach, prevalence was assessed from whole-body examinations in a cohort of 90 800 employees and from nationwide statutory health insurance (SHI) data of 2008. The number of cases documented in dermatological offices was estimated from statistics of a SHI Physicians Association.
Standardized prevalence of AK from dermatological examinations was 2.7%; the rate increased with age (11.5% in the group 60-70 years) and was higher for men (3.9%) than for women (1.5%). Significant associations were also identified for skin phototype I, sunburns in childhood and solar lentigines. Vitiligo and a history of melanoma were also, but not significantly, associated with AK. In the SHI data analysis, standardized AK prevalence was 1.8%. Age-specific rates were below 1.5% up to 60 years and rose to 8.2% (13.2% in men) in the group 80-89 years. The prevalence from these large data sets--which is at the lower limit of studies from other countries--suggests about 1.7 million estimated AK cases in Germany. In 2011, AK accounted for 8.3% of the hundred most frequently treated dermatological outpatient diagnoses. The proportion of AK cases has risen almost continuously over the last 10 years, compared to other dermatological conditions. Estimated annual number of AK cases documented by dermatologists in Germany is about 1.7 million.
Actinic keratosis is a frequent condition in higher age groups and more prevalent in men; a relevant need for health care is evident. Predictors and risk factors for AK are easy to identify in the population, which could also help to detect groups with special need for preventive measures.
在欧洲，仅有少量关于光化性角化病（AK）的流行率和治疗的数据，且这些数据并不一致。
确定德国 AK 的流行率，识别潜在的预测因素，并估计皮肤科诊所治疗的 AK 病例数。
采用多源方法，从 90800 名员工的全身检查和 2008 年全国法定健康保险（SHI）数据中评估流行率。从 SHI 医师协会的统计数据中估计皮肤科诊所记录的病例数。
皮肤科检查的 AK 标准化流行率为 2.7%；该比率随年龄增长而增加（60-70 岁组为 11.5%），男性（3.9%）高于女性（1.5%）。皮肤光型 I、儿童期晒伤和日光性雀斑也与 AK 显著相关。白癜风和黑色素瘤病史也与 AK 相关，但无统计学意义。在 SHI 数据分析中，标准化 AK 流行率为 1.8%。特定年龄组的比率在 60 岁以下低于 1.5%，在 80-89 岁组中上升至 8.2%（男性为 13.2%）。这些大型数据集的流行率——处于其他国家研究的下限——表明德国估计有 170 万 AK 病例。2011 年，AK 占 100 种最常治疗的皮肤科门诊诊断的 8.3%。与其他皮肤科疾病相比，过去 10 年来 AK 病例的比例几乎持续上升。德国皮肤科医生记录的 AK 病例年估计数约为 170 万。
光化性角化病是年龄较大人群中的常见疾病，男性更为常见；明显需要医疗保健。AK 的预测因素和危险因素在人群中很容易识别，这也有助于发现需要特殊预防措施的人群。
