Home' Australian Pharmacist : February 2013 Contents Australian Pharmacist February 2013 I © Pharmaceutical Society of Australia Ltd.
COUNSELLING IN PRACTICE
• Solar keratoses commonly occur in
people with fair skin and a history of
chronic sun exposure.
• Lesions are often accompanied by
signs of sun damage or photoageing
(e.g. fine lines and wrinkles, skin
discolouration and dryness).
• Cumulative sun exposure is the
single most important cause of solar
• The back of the hands and forearm
are the most commonly affected
• Solar keratoses can progress into
• Early detection and treatment
of solar keratoses reduces
non-melanoma skin cancer
1. Which of the following is NOT a
typical characteristic of solar
a) Wart-like appearance
c) Multiple lesions
d) Yellow in colour
2. Choose the CORRECT statement.
a) Squamous cell carcinoma can harden,
and become inflamed and ulcerated.
b) Solar keratosis should be suspected
when the lesion is present on a
covered part of the body.
c) Bowen’s disease causes yellow
thickened bumps to develop from
damaged elastin protein in the dermis.
d) Approximately 10–20% of Australians
aged over 40 years have >1 solar
3. In which of the following situations
is skin biopsy indicated to exclude
squamous cell carcinoma?
a) Advanced lesions
b) Recurrent lesions
c) Lesions unresponsive to therapy
d) All of the above
4. Which of the following clinical
situations would warrant lesion
a) Multiple lesions accompanied by signs
of extensive sun damage.
b) Several lesions that are widely
distributed on the hands and forearm.
c) A single lesion on the cheek where
scarring is of concern.
d) Numerous lesions on the scalp and
5. Choose the CORRECT statement
about field therapy.
a) 5-fluorouracil is best used on small to
medium areas about the size of a palm.
b) Topical diclofenac is the most potent
agent with the greatest risk of
chemical irritation and ulceration.
c) Imiquimod generally requires a long
treatment course of 90 days.
d) 5-fluorouracil helps to restore sun-
damaged skin, offering an additional
after 2 pm (before 11 am and after 3 pm
Daylight Saving Time), and applying
broad-spectrum sunscreen with at least
sun protection factor (SPF) 15 20 minutes
before going outside and reapplying at
least every 2 hours over sun-exposed
areas14 (see page 48 for more).
Where can I get more help?
Useful information resources for
• Cancer Council Australia website at:
• SunSmart Victoria website at: www.
• PSA Sense in the Sun Self Care Fact Card
Pharmacists can play an important role in
the early detection and referral of people
with abnormal skin lesions, especially
those with sun-damaged skin. People
presenting to the pharmacy with signs of
sun damage, especially those aged over
40 years, should be advised to visit their
doctor if they detect any skin changes
and to monitor for any:
• crusty, non-healing sores
• small lumps that are red, pale or pearly
• new spots, freckles or any moles
changing in colour, thickness or shape
over a period of weeks to months
(especially those dark brown to black,
red or blue-black in colour).14
1. Spencer JM. Actinic Keratosis. Medscape Reference. 2012. At:
2. Solar keratoses. DermNet NZ. 2012. At: www.dermnetnz.org/
3. Actinic keratosis. Best Practice – BMJ Evidence Centre. 2011. At:
4. Chia A, Moreno G, Lim A, et al. Actinic keratoses. Aust Fam
Physician 2007;36(7):539–41 .
5. Aging skin. DermNet NZ. 2012. At: www.dermnetnz.org/site-
6. de Berker D, McGregor JM, Hughes BR. Guidelines for the
management of actinic keratoses. Br J Derm 2007;156:222–30 .
7. Stanganelli I. Dermoscopy. Medscape Reference. 2012. At:
8. Rosendahl C, Cameron A, McColl I, et al. Dermatoscopy in
routine practice. Aust Fam Physician 2012;41(7):482–7 .
9. Sinclair R. Skin checks. Aust Fam Physician 2012;41(7):464–9 .
10. Squamous cell carcinoma. DermNZ. 2011. At: www.dermnetnz.
11. Thompson SC, Jolley D, Marks R. Reduction of solar keratoses
by regular sunscreen use. NEJM 1993;329(16):1147–51.
12. Actinic keratosis. Primary Care Dermatology Society. 2012.
13. Solar keratoses (sun spots). eTG complete. 2009. At: http://
14. Non-melanoma cancer. Cancer Council Australia. 2012. At:
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