Longitudinal Assessment of the Prevalence of Actinic Keratosis and Extensive Risk Factor Evaluation: An Update from the Rotterdam Study

Christopher D George; Selin Tokez; Loes Hollestein; Luba M Pardo; Anne J Keurentjes; Marlies Wakkee; Tamar Nijsten

doi:10.1016/j.jid.2023.02.042

Longitudinal Assessment of the Prevalence of Actinic Keratosis and Extensive Risk Factor Evaluation: An Update from the Rotterdam Study

J Invest Dermatol. 2023 Nov;143(11):2193-2203.e12. doi: 10.1016/j.jid.2023.02.042. Epub 2023 May 9.

Authors

Christopher D George¹, Selin Tokez², Loes Hollestein², Luba M Pardo², Anne J Keurentjes³, Marlies Wakkee², Tamar Nijsten⁴

Affiliations

¹ Departmentof Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Dermatology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.
² Departmentof Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
³ Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands.
⁴ Departmentof Dermatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: t.nijsten@erasmusmc.nl.

PMID: 37169068
DOI: 10.1016/j.jid.2023.02.042

Abstract

Population-based studies available to analyze the prevalence, risk factors, and longitudinal outlook of actinic keratoses (AKs) are limited. These features mentioned earlier were assessed using Rotterdam study participants aged ≥40 years who underwent a full-body skin examination by a dermatology-trained physician. ORs with 95% confidence intervals were calculated for the associations between risk factors and the presence of AK. Among 8,239 eligible participants, the prevalence of one or more AKs was 21.1% (95% confidence interval = 20.2-22.0) and was higher in men. Male sex, age, lighter hair and eye color, baldness, genetic risk score, and digital photoaging measures (digitally assessed pigmented spots, telangiectasias, and global facial wrinkling) had a positive association with AK. Cigarette smokers had reduced odds of having AK, with current smokers having the lowest risk. Among patients with two AK assessments, there was no difference in the presence of AK during follow-up between treated and untreated participants. In conclusion, genetic risk score and digital photoaging measures showed associations with increased lesion count. At the individual level, patients were most likely to decrease in AK severity group over time, possibly regardless of whether or not participants were treated.