Actinic Keratosis

Actinic keratosis is a form of precancer that can potentially turn into cutaneous squamous cell carcinoma (SCC). These precancerous scaly spots are commonly found on skin with the most skin damage.

Cause

Actinic keratosis occurs when short wavelength UVB damages DNA, leading to abnormal skin cell development. These precancerous lesions are fairly common and are more likely to appear with aging.

Clinical Features

Actinic keratoses can vary in appearance. These lesions can be flat, thick, white, yellow, rough, warty, red, skin colored, tender, or asymptomatic. Actinic keratoses are commonly found on skin with repeated sun-exposure, like the scalp, face, and backs of the hands.

Diagnosis

The diagnosis can be made clinically; your provider may use a dermatoscope to help view the lesion. Occasionally, actinic keratosis may be biopsied to exclude SCC or if treatment fails.

Complications

Patients with actinic keratoses have an increased risk (10-15%) of developing squamous cell carcinoma (SCC) when more than 10 are present. It is important to let your provider know if any suspicious spots change or increase in size, as this could indicate the need for treatment or biopsy.

Treatment

There are many different ways to treat actinic keratosis, which can be determined depending on size, number, and location. Actinic keratoses can be treated with liquid nitrogen spray, shave removal, electrocautery, topical medications, and photodynamic therapy (PDT). After treatment, it is important to practice strict sun protection to prevent further lesions.

Citation: Oakley, A. (2015). Actinic keratosis. DermNet. https://dermnetnz.org/topics/actinic-keratosis.

Written by Mariah Kalma, APRN

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