Disseminated Superficial Actinic Porokeratosis
Disseminated Superficial Actinic Porokeratosis (DSAP) is a chronic skin disorder that usually runs in families. It most commonly affects women and presents on the sun exposed parts of the skin. Most cases begin to develop between the ages of 20 and 40. Sunlight seems to stimulate formation of new lesions, so summertime finds exacerbations.
The rash of DSAP is quite distinct. Flat, round, eraser-sized to dime-sized patches are seen with a sharply defined, slightly elevated rim. Most of the time the small circles remain rough and persist. Occasionally, some will disappear. The concern with DSAP is that about 1 spot in 100 begins to change into a precancerous condition. These precancerous spots have the potential to become squamous cell skin cancer.
Precancerous change can be seen when one of the small spots begins to grow. It will grow both in diameter, and in thickness. The normally flat area becomes very thick and scaly. Those who have DSAP should watch for changing lesions, and if precancerous changes are suspected, let the dermatologist know.
Treatment of DSAP is usually observation with destruction of spots that are changing. These lesions are usually frozen with liquid nitrogen. Sometimes if there are many suspicious spots, a topical chemotherapy agent can be applied. This topical can destroy many early precancerous lesions. The other important thing to remember with DSAP is prevention. Regular use of a broad-spectrum sunscreen with a high SPF (30+) is a must. In addition, sun protective clothing or straight sun avoidance is recommended during the hottest parts of the day.