Clinical Reference / Therapeutic Strategies / Actinic Keratosis (a.k.a. Solar Keratosis)

Actinic Keratosis (a.k.a. Solar Keratosis)


Key Points

  • Actinic keratoses (AKs) are the most common epithelial precancerous skin lesions.
  • They present as scaly, erythematous, ill-defined papules on sun-exposed areas.
  • A small percentage of AKs may progress to non-melanoma skin cancer (NMSC) over a lifetime.
  • Therapy is determined by anatomic location and number of lesions.

Introduction

Actinic keratoses (AKs) typically present as scaly, erythematous papules or plaques on sun-exposed areas, and are the most common epithelial precancerous skin lesions. Clinical variants of AKs include: erythematous, atrophic, hyperkeratotic, pigmented and lichenoid forms. AKs on the lower lip are termed actinic cheilitis. Treatment is necessary because approximately 2-15% of lesions may progress to non-melanoma cutaneous skin cancer (NMSC).

Three strategies for treatment are most frequently employed:

  1.  Physical destruction
  2.  Topical chemotherapy
  3.  Local stimulation of the immune system

Therapy is determined by location (face, scalp, forearms or legs) and extent (few versus multiple).

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