Chronic keratotic lesions on adult skin that has been chronically exposed to ultraviolet (UV) rays.
Has the potential to progress into an invasive squamous cell carcinoma (SCC).
Although diagnosed clinically, a biopsy may help to rule out SCC.
Treatment consists of destructive methods (e.g., cryotherapy with liquid nitrogen, curettage with or without electrodesiccation, chemical peels, and photodynamic therapy) or topical medication (e.g., topical fluorouracil, imiquimod, diclofenac).
Actinic keratosis (AK) lesions are skin-coloured, yellowish, or erythematous, ill-defined, irregularly shaped, small, scaly macules or plaques localised in sun-exposed areas of the body. Typically, they occur in middle-aged or older men with light-coloured skin and a history of chronic sun exposure. They can potentially progress into squamous cell carcinoma (SCC).
History and exam
- presence of risk factors
- single or multiple scaly macules or plaques
- scaly lesions with a hyperkeratotic surface
- well-defined, scaly, brown lesions
- lesions resembling seborrhoeic keratosis, melanocytic naevus, and early malignant melanoma
- hypertrophic conical-shaped protuberances growing from the surface of the skin
- scaly red roughness with induration, fissuring, and ulceration of the lower lip to the commissures
- lesion on sun-exposed area of body
- skin-coloured, papillomatous, elevated wart-like papules
- plaques with very mild scale over very thin shiny skin
- violaceous well-defined papules with fine white lines on the surface
Brian Berman, MD, PhD
Professor Emeritus of Dermatology and Cutaneous Surgery
University of Miami Miller School of Medicine
Skin & Cancer Associates, LLP
Center for Clinical and Cosmetic Research
BB has acted as an investigator for and received research support from Medicis, LEO Pharma, DUSA, and Ferndale. He has also been a consultant and on the speakers' bureau of Medicis, LEO Pharma, DUSA, Dermira, Novartis, Galderma, Ferndale, Berg, Pharmaderm, Valeant, Pfizer, and Biofrontera.
Sadegh Amini, MD
Hollywood Dermatology and Cosmetic Specialists
Voluntary Assistant Professor
Department of Dermatology and Cutaneous Surgery
University of Miami
Miller School of Medicine
Department of Dermatology
Jackson Memorial Hospital
SA declares that he has no competing interests.
David S. Cassarino, MD, PhD
Departments of Pathology and Dermatology
DSC declares that he has no competing interests.
Christopher Shea, MD
Dermatopathology Fellowship Director
University of Chicago
Section of Dermatology
CS declares that he has no competing interests.
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