Actinic Keratosis: A Case Report

日光角化症－病例報告

10.29461/TGGa.202311_18(4).0006

Guan-Hong Lin(林冠宏)；Chieh Chen(陳杰)

Pre-cancerous squamous cell lesion ； actinic keratosis ； ultraviolet radiation ； squamous cell carcinoma in situ ； 鱗狀細胞癌前病變 ； 日光性角化症 ； 紫外線輻射 ； 原位鱗狀細胞癌

台灣老年醫學暨老年學會雜誌

18卷4期（2023 / 11 / 01）

315 - 324

英文;繁體中文

A 94-year-old woman visited our clinic due to itching and pain on the scalp and back, but it was not a typical dermatitis. It was a skin precancerous lesion caused by skin keratinization that might develop into cancer. Primary care physicians should be alert to this skin disease. Actinic keratosis, one of the most common precancerous skin conditions, is an early skin lesion of squamous cell cancer caused by cumulative ultraviolet radiation from sun exposure. Squamous cell carcinoma of the skin is usually present in the basal layer of epidermis as early as adolescence. Therefore, it is necessary to avoid excessive sun exposure at young age to appropriately prevent actinic keratosis of the skin. Frontline physicians practicing medicine in rural and fishing villages in particular need to pay close attention to discover skin lesions early and provide treatment or refer patients to specialists for further treatment. Primary care physicians should teach rural and fishing village residents how to regularly follow up on the progress of skin lesions related actinic keratosis so as to help prevent the disease from developing into skin cancer.

一位94歲女性，因頭皮及背部皮膚搔癢與疼痛來門診，但不是一般典型的皮膚炎，而是可能演變為癌症的一種皮膚角質化病變，基層醫師對於這一種皮膚疾病應提高警覺。日光性角化症是陽光中的紫外線照射皮膚所引起的皮膚鱗狀細胞癌症的早期皮膚病變，亦是人類最常見之皮膚癌症之一。皮膚的鱗狀細胞癌細胞其實早在青少年時期，就已經存在於皮膚的表皮基底層當中。因此要適度的預防日光性角化症進展成皮膚的鱗狀細胞癌，年輕時就應該避免陽光過度曝曬，尤其是在農漁村執業的第一線醫師，更應早期發現病患的皮膚病變，給予治療或轉介專科醫師進一步治療，並且衛教患者如何預防及定期回診追蹤日光性角化症的皮膚病變。