Patients' perspectives on actinic keratosis.

Many factors influence patients' perspectives on actinic keratosis (AK). The wish to keep a sense of control prompts many to seek information, which they then interpret according to their personal perspective. Speculations regarding the risk of getting skin cancer and emotional reactions may be expected due to worries about the worsening of the condition, losing control, and participating in UV-related activities. In their contact with physicians, treatment can be an additional issue. Treatment of AK may cause pain and may in itself result in a perceived diminished quality of life. The Actinic Keratosis Quality of Life questionnaire can be used as a valuable tool to represent the effects of treatment on quality of life and to classify patient subpopulations. Studies have suggested that AK patients are more compliant compared to those with other skin diseases. Still fear of stigmatisation may be present during treatment, which may disturb social life. Social and personal factors are crucial to patients' coping strategies, and financial aspects may have an impact on advisable UV-related behaviours. Some AK patients may benefit from interventions to improve their stress response capacity. The clear causality of AK requires a change in behaviour, which is met by multi-conditioned resistance. The physician should be aware that patients might feign acceptance but justify continued UV exposure to themselves with a variety of arguments. Tanning is of great importance for the self-esteem of many AK patients, and tanning addiction should be considered.