Abstract

Background: Actinic keratoses are precancerous lesions related to excessive ultraviolet exposure, representing an emerging issue around skin diseases. They have a potential risk for developing squamous cell carcinoma and present cosmetic problems.

Objective: To evaluate the effectiveness and side effects of Fractional Ablative CO2 laser in treating AKs.

Patients and Methods: This interventional study was performed in Baghdad Dermatology Center from February 2022 to October 2023. Any patient with actinic keratosis lesion consulting the centre was included in the study. A thorough history was taken regarding the duration, symptoms, history of SCC, occupation (indoor or outdoor), medical illnesses and drug history. Lesions were diagnosed clinically in most cases, but biopsy was done for suspicious cases. The lesions were treated with CO2 laser fractional ablation mode (DEKA device). At 2 and 4 weeks, the lesions were assessed for remaining lesions and side effects.

Results: a total of 93 lesions from 16 patients, 11 males and five females, mean age 63.6 years, skin photo-types 2/3, were included in the study. They were treated with (1-4) sessions with 1-month intervals according to the lesional response. Only topical anaesthesia was used, which was enough to control pain during the procedure. The number of lesions was reduced with each session, and at the end of four months, there were only 37 out of 93 lesions, and all these were reduced in size. The grading of the remaining lesions was also reduced at the end of the study. We had 20 lessons in grade 3, while in the end, only nine lesions remained in grade 3. Patients reported reasonable satisfaction rates. Side effects, including pain and erythema, were minimal and transitory.

Conclusion. The ablative fractional CO2 laser is an effective modality to treat AKs, especially for scalp and facial lesions, with few side effects.