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Keratosis, Actinic

Zoltan Trizna, MD, PhD Reviewed 06/2019
 


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 the...

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 activiti...

REFERENCES

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

ADDITIONAL READING

Feldman SR, Fleischer ABJr. Progression of actinic keratosis to squamous cell carcinoma revisited: clinical and treatment implications. Cutis.  2011;87(4):201–207. [View Abstra...

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, although most will not progress to squamous cell cancer and many will regress with time.

  • Often more easily felt than seen

  • Therapy-resistant lesions should b...

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