How is actinic keratosis (AK) characterized?

Updated: Jan 30, 2020
  • Author: Ginard I Henry, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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These lesions may present on a patient as young as 20 years but are most commonly noticed in individuals older than 50 years. Men are more affected than women. Persons at increased risk for developing actinic keratoses are those who live in warmer, sunnier climates and those who have outdoor professions or hobbies. Immunosuppressed individuals (typically those with a history of organ transplant or lymphoma, or those receiving psoralen and UVA light treatment) are at high risk of developing actinic keratoses and malignant transformation into squamous cell carcinoma with higher rates of metastasis.

These lesions may demonstrate certain excrescences of keratin, referred to as cutaneous horns. The rough texture of the lesion imparts to the skin a sandpaper-like consistency. The color may be red, yellow, brown, or gray. Actinic keratosis may bear a clinical resemblance to psoriasis, Bowen disease, or Paget disease. The most important attribute is its premalignant potential. The annual incidence of malignant transformation from actinic keratosis to squamous cell carcinoma varies from 0.25-29.0% per year per individual lesion.

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