Ferrándiz C, Plazas M J, Sabaté M, Palomino R
Servicio de Dermotología, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
Medical Department Spain, Almirall, Barcelona, Spain.
Actas Dermosifiliogr. 2016 Oct;107(8):674-80. doi: 10.1016/j.ad.2016.05.016. Epub 2016 Jul 18.
Actinic keratoses (AKs) are common skin lesions associated with an increased risk of developing squamous cell carcinoma. Few studies in Europe have focused on AK prevalence.
To determine the point prevalence of AKs in a dermatology outpatient population in Spain, to describe the clinical characteristics of these lesions and to characterise the profile of AK patients.
Observational, cross-sectional, multicentre study conducted in 19 hospitals (dermatology outpatient services) around Spain. A total of 204 consecutive patients per hospital who were ≥45 years old were screened for the presence of AKs.
3877 patients were assessed and the overall AKs prevalence was 28.6%. Prevalence was significantly higher in men than women (38.4% vs. 20.8%, p<0.0001) and increased with age for both sexes (45.2% in 71-80 years). Scalp and ear lesion locations were significantly more frequent in men (51.9% vs. 2.7% and 16.9% vs. 2.4%, respectively, p<0.0001 both cases) and the cheek, nose and neckline in women (46.3% vs. 34.0% [p<0.0001], 43.0% vs. 24.8% [p<0.0001] and 5.3% vs. 1.8% [p=0.002]). Men showed a significantly higher frequency of ≥2 affected areas than women (42.7% vs. 20.3%, p<0.0001). Among patients with AK lesions, only 65% confirmed that they were the reason for the visit to the clinic.
Approximately a quarter of the dermatology outpatient population in Spain aged ≥45 years old have AKs, with the prevalence rate being highest in men and in older age groups. AK is underdiagnosed and a proactive strategy is needed for the diagnosis and early treatment of these lesions.
光化性角化病（AK）是常见的皮肤病变，与鳞状细胞癌发生风险增加相关。欧洲很少有研究关注AK的患病率。
确定西班牙皮肤科门诊人群中AK的现患率，描述这些病变的临床特征，并对AK患者的特征进行描述。
在西班牙各地的19家医院（皮肤科门诊服务）进行观察性、横断面、多中心研究。每家医院共筛选了204名年龄≥45岁的连续患者，以检查是否存在AK。
共评估了3877例患者，AK的总体患病率为28.6%。男性患病率显著高于女性（38.4%对20.8%，p<0.0001），且两性患病率均随年龄增长而增加（71 - 80岁人群中为45.2%）。男性头皮和耳部病变部位明显更常见（分别为51.9%对2.7%和16.9%对2.4%，两种情况p均<0.0001），而女性的脸颊、鼻子和领口部位更常见（46.3%对34.0% [p<0.0001]，43.0%对24.8% [p<0.0001]，5.3%对1.8% [p = 0.002]）。男性≥2个受累区域的频率显著高于女性（42.7%对20.3%，p<0.0001）。在有AK病变的患者中，只有65%确认这是他们就诊的原因。
西班牙≥45岁的皮肤科门诊人群中约四分之一患有AK，患病率在男性和老年人群中最高。AK存在漏诊情况，需要采取积极策略对这些病变进行诊断和早期治疗。
