Curettage and Cryotherapy of Actinic Keratosis

Curettage and Cryotherapy of Actinic Keratosis

Curettage and cryotherapy of actinic keratosis.

Actinic keratosis is typically an erythematous, rough spot on a skin area exposed to light. Before cryotherapy, visible superficial hyperkeratosis should be removed by curettage. At the same time, it can be confirmed that there is no deeper ulceration, mushy plaque or tissue thickening under the hyperkeratosis. In such cases, the histological diagnosis should be confirmed by skin biopsy. In actinic keratosis, after the removal of hyperkeratosis, the area is typically smooth, showing only superficial erosion due to curettage.

After curettage, any superficial bleeding can be stopped by using an aluminium or ferric chloride solution (in this video, aluminium chloride is used). The solution should be allowed to exert its effect for a while; there may be smarting. Cryotherapy of actinic keratoses should be done by freezing the lesion thoroughly, making sure that the frozen area extends slightly beyond the margin. The total freeze time is usually 5-20 seconds depending on the skin area (for the face, 5-10 seconds is usually sufficient). In this case, the freeze time was about 10 seconds because the lesion was a thin actinic keratosis on the face.

After complete thawing, the treatment should be repeated, i.e. 2 freeze cycles per treatment session are normally used for an actinic keratosis. The patient should be informed that the area may be erythematous and tender for a few days. It can be washed normally.

Video: Timo Ruohoalho, text: Alexander Salava