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Topical diclofenac in the treatment of actinic keratoses

A privilege for dermatologists is the capability to observe fundamental biological processes through the diagnosis and treatment of skin diseases, for example, the possibility to observe premalignant lesions and how they develop into a malignancy. Actinic keratosis (AK) is one such skin lesion, which is caused by excessive exposure to ultraviolet (UV) radiation and can progress into squamous cell carcinoma (SCC). It is therefore of serious clinical concern. The American Academy of Dermatology estimates that 60% of predisposed individuals aged 40 years and over have at least one AK, making it the most common form of precancerous skin lesion. 1 The prevalence of AK is higher in men than in women, increases with age, and is more frequently observed in fairrather than dark-skinned individuals. Other predisposing factors include immunosuppression, papillomavirus infection, and certain genetic conditions such as xeroderma pigmentosum. 1,2 Skin tumors, including SCC, basal cell carcinoma (BCC), and malignant melanoma (MM), are the most frequent types of malignant tumor. Together, these skin tumors account for the highest rate of mortality amongst heart and kidney transplant patients. 2