Last reviewed: March 2019
Last updated: February  2018

Summary

Definition

History and exam

Key diagnostic factors

  • single or multiple scaly macules or plaques
  • scaly lesions with a hyperkeratotic surface
  • well-defined, scaly, brown lesions
  • lesions resembling seborrheic keratosis, melanocytic nevus, 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-colored, papillomatous, elevated wartlike papules
  • plaques with very mild scale over very thin shiny skin
  • violaceous well-defined papules with fine white lines on the surface
Full details

Other diagnostic factors

  • evidence of sun damage to skin
  • pruritus or bleeding
Full details

Risk factors

  • chronic exposure to UVB radiation
  • light-colored skin, freckling, and albinism
  • age >40 years
  • male gender
  • immunocompromise
  • xeroderma pigmentosum
Full details

Diagnostic investigations

Investigations to consider

  • dermoscopy
  • skin biopsy
Full details

Treatment algorithm

ONGOING

confluent scalp lesions

head and face lesions, excluding periorbital, actinic cheilitis, and confluent scalp lesions

periorbital

actinic cheilitis

back of hands

below the knee

Contributors

Authors VIEW ALL

Brian Berman

Professor Emeritus of Dermatology and Cutaneous Surgery

University of Miami Miller School of Medicine

Miami

Skin & Cancer Associates, LLP

Co-Director

Center for Clinical and Cosmetic Research

Aventura

FL

Disclosures

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

Dermatologist

Hollywood Dermatology and Cosmetic Specialists

Hollywood

Voluntary Assistant Professor

Department of Dermatology and Cutaneous Surgery

University of Miami

Miller School of Medicine

Miami

Staff

Department of Dermatology

Jackson Memorial Hospital

Miami

FL

Disclosures

SA declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor

Departments of Pathology and Dermatology

UCLA

Los Angeles

CA

Disclosures

DSC declares that he has no competing interests.

Dermatopathology Fellowship Director

University of Chicago

Section of Dermatology

Chicago

IL

Disclosures

CS declares that he has no competing interests.

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