Prospective Quality of Life Impact of Actinic Keratoses: Observations from the Veterans Affairs Topical Tretinoin Chemoprevention Trial

Actinic keratoses (AKs) are common dysplastic lesions with potential to transform into keratinocyte carcinomas (KC; basal and squamous cell carcinomas) (1), and they present a substantial cost because they are so common (2). A recent cross-sectional analysis found that higher AK counts and past use of topical 5-fluorouracil (5-FU) are predictors of worse quality of life (QoL), with 5-FU usage being an indication of a large number of AKs in the past (3). Given these associations, our rationale for this study was to determine whether QoL is associated prospectively with increases in AK counts in a population with history of multiple KCs.