{"id":9254,"date":"2018-05-04T07:52:01","date_gmt":"2018-05-04T07:52:01","guid":{"rendered":"http:\/\/old.institutcataladelpeu.com\/?p=9254"},"modified":"2018-05-04T14:24:20","modified_gmt":"2018-05-04T14:24:20","slug":"la-queratosi-actinica-el-pre-cancer-de-pell-mes-frequent","status":"publish","type":"post","link":"https:\/\/old.institutcataladelpeu.com\/ca\/la-queratosi-actinica-el-pre-cancer-de-pell-mes-frequent\/","title":{"rendered":"La queratosi act\u00ednica. El pre-c\u00e0ncer de pell m\u00e9s freq\u00fcent."},"content":{"rendered":"

La queratosi act\u00ednica o m\u00e9s coneguda com a taques solars \u00e9s una lesi\u00f3 degenerativa i proliferant de les c\u00e8l\u00b7lules de l’epidermis que presenten petites elevacions i aspror de la pell. Les lesions s\u00f3n de color vermell\u00f3s o marronaci, crostoses i similars a berrugues amb inflamaci\u00f3 perilesional. De vegades remeten i tornen a apar\u00e8ixer donant una sensibilitat dolorosa o de cremor. La queratosi act\u00ednica pot ser una precursora del c\u00e0ncer de pell com el carcinoma de c\u00e8l\u00b7lules escamoses.<\/p>\n

La queratosi act\u00ednica est\u00e0 provocada per l’exposici\u00f3 continuada a la llum solar, encara que existeixen altres factors que n\u2019afavoreixen l\u2019aparici\u00f3. Aquests factors s\u00f3n la susceptibilitat gen\u00e8tica, la pell clara, persones amb cabell ros o cauc\u00e0siques, persones d’ulls verds o blaus, els medicaments immunodepressors, el trasplantament d’algun \u00f2rgan i les cremades solars greus en edats primerenques., aix\u00ed com persones amb edats superiors a 50 anys. \u00c9s una patologia que afecta m\u00e9s a homes que a dones i apareix a la cara, \u00e0rees alop\u00e8ciques del cuir cabellut, espatlles, mans, etc.<\/p>\n

La prevalen\u00e7a de la queratosi act\u00ednica ha augmentat en els \u00faltims 10 anys respecte a altres dermatosis, i se\u2019n preveu un augment en el futur.<\/p>\n

El 10% de les queratosis act\u00edniques malignitzen a un carcinoma de c\u00e8l\u00b7lules escamoses o espinocelulars i aproximadament el 50% dels carcinomes de c\u00e8l\u00b7lules escamoses amb una queratosi act\u00ednica no tractada. Com m\u00e9s gran sigui la queratosi act\u00ednica, major \u00e9s la probabilitat que una o m\u00e9s es converteixin en un c\u00e0ncer de pell.<\/p>\n

Actualment, per a alguns experts, la queratosi act\u00ednica s’est\u00e0 classificant com un aut\u00e8ntic carcinoma escam\u00f3s cutani in situ en compartir caracter\u00edstiques morfol\u00f2giques i canvis citogen\u00e8tics. No ho consideren un precursor del carcinoma de c\u00e8l\u00b7lules escamoses sin\u00f3 un estadi inicial del propi carcinoma. El diagn\u00f2stic \u00e9s cl\u00ednic, encara que en casos dubtosos \u00e9s recomanable una bi\u00f2psia cut\u00e0nia. La descamaci\u00f3 i la palpaci\u00f3 de la hiperqueratosi ajuda al diagn\u00f2stic, aix\u00ed com la pres\u00e8ncia d’arrugues, pell atr\u00f2fica o alteracions pigment\u00e0ries.<\/p>\n

Les queratosis act\u00edniques han de tractar-se el m\u00e9s preco\u00e7ment possible per evitar-ne l\u2019evoluci\u00f3.<\/p>\n

Aquests tractaments es divideixen en tractaments de lesions a\u00efllades i tractaments del camp de canceritzaci\u00f3. S’usen combinats en queratosi act\u00ednica cr\u00f2nica i no s\u00f3n excloents entre si, encara que l\u2019elecci\u00f3 terap\u00e8utica dependr\u00e0 de les caracter\u00edstiques del pacient, nombre i localitzaci\u00f3 de lesions, aix\u00ed com dels tractaments previs rebuts. Els m\u00e9s comuns s\u00f3n:<\/p>\n

1) Cremes t\u00f2piques mentre la lesi\u00f3 no degeneri com per exemple el 5-Fluorouracil al 0\u20195% m\u00e9s \u00e0cid salic\u00edlic al 10% o l\u2019imiquimod.<\/p>\n

2) Electrocirurg\u00eda sota anest\u00e8sia local.<\/p>\n

3) Fototer\u00e0pia, recomanada en lesions m\u00faltiples no hiperquerat\u00f2siques. Consisteix en l’aplicaci\u00f3 d’un fotosensibilitzant t\u00f2pic ocl\u00f2s durant 2 o 3 hores i la il\u00b7luminaci\u00f3 posterior de la zona amb una font de llum apropiada.<\/p>\n

4) Peeling qu\u00edmic.<\/p>\n

5) Crioter\u00e0pia; aplicaci\u00f3 de nitrogen l\u00edquid sobre la lesi\u00f3 per provocar necrosi i eliminaci\u00f3 de la lesi\u00f3. Recomanada en lesions a\u00efllades.<\/p>\n

6) Curetatge: eliminaci\u00f3 de la queratosi act\u00ednica mitjan\u00e7ant bistur\u00ed.<\/p>\n

 <\/p>\n

Els consells en pacients amb antecedents de queratosi act\u00ednica s\u00f3n els seg\u00fcents:<\/p>\n

a) Revisi\u00f3 de les taques cut\u00e0nies. L’aparici\u00f3 de signes com el canvi de color, forma o grand\u00e0ria d’una taca podria reflectir l’aparici\u00f3 d’un c\u00e0ncer de pell. \u00c9s recomanable visitar el dermat\u00f2leg en aquests casos.<\/p>\n

b) Reduir l’exposici\u00f3 al sol sobretot entre les 11h a les 16 h i utilitzar ulleres al sol, barrets i roba adequada. Encara que el dia estigui ennuvolat, no es pot menystenir l’acci\u00f3 dels rajos ultraviolats.<\/p>\n

c) Utilitzar protecci\u00f3 solar trenta minuts abans a l’exposici\u00f3 solar i un factor de protecci\u00f3 m\u00e9s alt com m\u00e9s clara sigui la tonalitat de la pell. L’exposici\u00f3 al sol \u00e9s m\u00e9s intensa a principis d’estiu i el risc de cremades \u00e9s superior a majors altituds.<\/p>\n

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La queratosi act\u00ednica o m\u00e9s coneguda com a taques solars \u00e9s una lesi\u00f3 degenerativa i proliferant de les c\u00e8l\u00b7lules de l’epidermis que presenten petites elevacions i aspror de la pell. Les lesions s\u00f3n de color vermell\u00f3s o marronaci, crostoses i similars a berrugues amb inflamaci\u00f3 perilesional. De vegades remeten i tornen a apar\u00e8ixer donant una […]<\/p>\n","protected":false},"author":3,"featured_media":9250,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[276,282,346,306],"tags":[],"class_list":["post-9254","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-alteracions-dermatologiques","category-articles","category-icp-ca","category-patologia-ca"],"yoast_head":"\nLa queratosi act\u00ednica. 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