Actinic Keratosis

Keratosis Pilaris Cure

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Figure 32-8. Actinic keratoses. (Dermik Laboratories, Inc.; Owen Laboratories, Inc.)

Actinic keratosis is a common skin lesion of light-complexioned older persons that occurs on the skin surfaces exposed to sunlight. A small percentage of these lesions develop into squamous cell carcinomas. Because of the popularity of sunbathing, these lesions (probably 5-10%) are seen also in persons in the 30- to 50-year-old age group.

DESCRIPTION. Lesions are usually multiple, flat or slightly elevated, brownish or tan colored, scaly and adherent, measuring up to 1.5 cm in diameter, and often arising on an ill-defined base (Fig, 32-?). Individual lesions may become confluent. A cutaneous horn may be a proliferative, hyperkeratotic form of actinic keratosis that resembles a horn (Fig 32ii0). A cutaneous horn can also originate from a seborrheic keratosis, wart, squamous cell carcinoma, basal cell carcinoma, or keratoacanthoma. If a biopsy is done, enough of the base of the lesion must be removed to obtain an accurate histologic diagnosis.

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Figure 32-9. Actinic keratoses. (Dermik Laboratories, Inc.; Owen Laboratories, Inc.)

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Figure 32-10. Cutaneous horn.

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Figure 32-10. Cutaneous horn.

DISTRIBUTION. Areas of skin exposed to sunlight, such as face, ears, neck, and dorsum of hands, are involved.

COURSE. The lesion begins as a faint red, slightly scaly patch that enlarges slowly, peripherally and deeply, over many years. A sudden spurt of growth could indicate a change to a squamous cell carcinoma.

SUBJECTIVE COMPLAINTS. Patients often complain that these lesions are sensitive or they burn and sting.

ETIOLOGY. Heredity and sun exposure are the two main causative factors. The blue-eyed, thin-skinned, light-haired person with a family history of such lesions is the best subject for multiple actinic keratoses.

SEX INCIDENCE. The disorder is most commonly seen in men.

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