What are the risk factors for severe actinic keratosis?

Older age, lower skin phototype classifications, and a personal history of skin cancer may influence the severity of actinic keratosis (AK), while the use of calcium channel blockers (CCBs) is linked to more severe AK, as reported in a study.

This multicentre cross-sectional study included 270 immunocompetent adults between 39 and 92 years of age. These participants had at least one AK on their face or scalp. Researchers evaluated demographic factors, sun exposure and protection, history of skin cancer, and medication use within the last 6 months.

The Actinic Keratosis Area and Severity Index (AKASI) score was the primary outcome. Variation in AKASI scores, adjusting for gender, age, and skin phototype, was also assessed using a hierarchical generalized linear model.

Most of the participants had phototype I or II (77 percent), were men (51 percent), had a personal history of skin cancer (55 percent), and had low adherence to sunscreen use (29 percent). Around 61 percent of the participants reported use of photosensitizing medications.

Multivariate analysis showed AK severity to be associated with older age (β_SE=0.14; p<0.01), lighter skin phototype (β_SE=0.15; p=0.01), history of skin cancer (β_SE=0.12; p<0.01), sunburning (β_SE=0.12; p<0.01), and use of CCBs (β_SE=0.11; p=0.02).

Use of photosensitizing drugs had no association with AK severity.