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General Medicine

Keratosis, Actinic

Zoltan Trizna, MD, PhD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Common, usually multiple, premalignant lesions of sun-exposed areas of the skin. Many resolve spontaneously, and a small proportion progresses to squamous cell carcinoma (SCC).

  • Common...

DIAGNOSIS

HISTORY

  • The lesions are frequently asymptomatic; symptoms may include pruritus, burning, and mild hyperesthesia.

  • Lesions may enlarge, thicken, or become more scaly. They also may regress or re...

TREATMENT

First-line treatment is cryotherapy (technically, this is considered surgery, especially by insurance companies) (1,2)[A]. Medical therapy is usually reserved for extensive AKs (“field thera...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

Depends on associated malignancy and frequency with which new AKs appear 

PATIENT EDUCATION

  • Teach sun-protective techniques.

    • Limit outdoor activi...

REFERENCES

1
Helfand M, Gorman AK, Mahon S, et al. Actinic Keratoses. Rockville, MD: Agency for Healthcare Research and Quality; 2001. [View Abstract on OvidMedline]
2
de Berker D, McGregor JM, Hughes B...

ADDITIONAL READING

  • Kanellou P, Zaravinos A, Zioga M, et al. Genomic instability, mutations and expression analysis of the tumour suppressor genes p14(ARF), p15(INK4b), p16(INK4a) and p53 in actinic ke...

CODES

ICD10

L57.0 Actinic keratosis 

ICD9

702.0 Actinic keratosis 

SNOMED

  • 201101007 Actinic keratosis (disorder)

  • 254667001 Hypertrophic solar keratosis

  • 403200005 Atrophic actinic keratosis

  • 403198004 lichenoid...

CLINICAL PEARLS

  • AKs are premalignant lesions.

  • Often more easily felt than seen

  • Therapy-resistant lesions should be biopsied, especially on the face.

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Related Images
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actinic keratosis: numerous keratoses over te scalp induced by chronic ultra-voilet exposure
actinic keratosis: numerous keratoses over te scalp induced by chronic ultra-voilet exposure
Solar keratosis. Note the erosions and crusting on the lower lip of this elderly patient. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Solar keratosis. Note the erosions and crusting on the lower lip of this elderly patient. From Goodheart HP. Goodheart's Photoguide to Comm...
Squamous cell carcinoma. This nodular lesion arose from a solar keratosis. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Squamous cell carcinoma. This nodular lesion arose from a solar keratosis. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorde...
Solar keratoses, hypertrophic. The solar keratoses occur primarily in areas of sun-exposed skin in this elderly woman. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Solar keratoses, hypertrophic. The solar keratoses occur primarily in areas of sun-exposed skin in this elderly woman. From Goodheart HP. G...
Solar keratosis. This cutaneous horn was also produced by an underlying solar keratosis. A biopsy was performed to rule out squamous cell carcinoma. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Solar keratosis. This cutaneous horn was also produced by an underlying solar keratosis. A biopsy was performed to rule out squamous cell c...
Actinic keratosis
Actinic keratosis
Actinic Keratosis Actinic keratoses are superficial, flattened papules covered by a dry scale. Often multiple, they may be round or irregular, and are pink, tan, or grayish. They appear on sun-exposed skin of older, fair-skinned persons. Though themselves benign, these lesions may give rise to squamous cell carcinoma (suggested by rapid growth, induration, redness at the base, and ulceration). Keratoses on face and hand, typical locations, are shown.
Actinic Keratosis Actinic keratoses are superficial, flattened papules covered by a dry scale. Often multiple, they may be round or irregul...
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