Evaluation of Factors Associated with a History of Skin Cancer in Patients with Actinic Keratosis: AKASI as a Clinical Tool for Risk Stratification

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Aim:We aimed to investigate the clinical, demographic, and laboratory factors associated with a personal history of skin cancer in patients with actinic keratosis (AK), incorporating the actinic keratosis area and severity index (AKASI) and systemic inflammatory markers to identify potential risk factors for malignancy. Materials and Methods:This single-center, cross-sectional study enrolled 110 patients with AK.Participants were categorized as having a histopathologically confirmed personal history of skin cancer (n = 33) or no personal history of skin cancer (n = 77).Demographic data, clinical characteristics, AKASI scores, and systemic inflammatory indices derived from complete blood counts were collected.Between-group comparisons were performed using appropriate statistical tests.Results: Patients with a history of skin cancer were significantly older (73.6 ± 12.5 vs. 69.0± 9.3 years; P = 0.036), had longer AK duration (median, 60 vs. 36 months; P = 0.003), and had higher total AKASI scores (median, 5.4 vs. 3.9; P = 0.044) than those without a history of skin cancer.Right facial AKASI scores were also significantly higher (P = 0.035).Receiver operating characteristic analysis identified a total AKASI cut-off of 3.75, with fair discriminatory performance (area under the curve = 0.621, P = 0.044).No significant differences were observed in systemic inflammatory indices, including the neutrophil-to-lymphocyte ratio (NLR), derived NLR, platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio, mean platelet volume-to-platelet ratio, systemic immune-inflammation index, and systemic inflammation response index, between groups.Conclusion: Older age, longer disease duration, and greater AK severity, as measured by AKASI, are associated with a personal history of skin cancer among patients with AK, whereas systemic inflammatory indices are not associated.AKASI may be useful for clinical risk stratification and patient surveillance.

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