Materiały źródłowe

• #1 Actinic keratoses (Solar keratosis): Diagnosis and Treatment — DermNet

  https://dermnetnz.org/topics/actinic-keratosis

  Actinic keratosis is a precancerous scaly spot found on sun-damaged skin, also known as solar keratosis. It may be considered an early form of cutaneous squamous cell carcinoma (a keratinocyte cancer). […] Actinic keratosis is usually easy to diagnose clinically or by dermoscopy. Occasionally, a biopsy is necessary, for example, to exclude SCC, or if treatment fails. […] The main concern is that actinic keratoses indicate an increased risk of developing cutaneous squamous cell carcinoma. It is rare for a solitary actinic keratosis to evolve to squamous cell carcinoma (SCC), but the risk of SCC occurring at some stage in a patient with more than 10 actinic keratoses is thought to be about 10 to 15%. […] Actinic keratoses are prevented by strict sun protection. If already present, actinic keratoses may improve with a very high sun protection factor (50+) broad-spectrum sunscreen applied at least daily to affected areas, year-round.

• #2 Actinic Keratosis: Risk Factors, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14148-actinic-keratosis

  Actinic keratosis (AK) causes rough, scaly skin patches. Left untreated, AK can lead to a skin cancer called squamous cell carcinoma. […] If you notice new red or rough bumps on your skin, call your healthcare provider for diagnosis and treatment. […] Actinic keratosis (AK) is a skin disorder that causes rough, scaly patches of skin. Another name for AK is solar keratosis. […] Without treatment, AK can lead to a type of skin cancer called squamous cell carcinoma. […] Your primary care provider, a dermatologist, (provider specializing in skin conditions) or other healthcare provider can often diagnose actinic keratosis by carefully examining your skin and using magnification. […] If your healthcare provider is uncertain or the skin looks unusual, she/ he may recommend a skin biopsy.

• #3 Actinic keratosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/actinic-keratosis/diagnosis-treatment/drc-20354975

  Your health care provider will likely be able to determine whether you have an actinic keratosis simply by looking at your skin. If there’s any doubt, your health care provider may do other tests, such as a skin biopsy. During a skin biopsy, a small sample of skin is taken for analysis in a lab. A biopsy can usually be done in a clinic after a numbing injection. […] Even after treatment for actinic keratosis, your health care provider might suggest that you have your skin checked at least once a year for signs of skin cancer.

• #4 Actinic Keratosis: Risk Factors, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14148-actinic-keratosis

  Actinic keratosis (AK) causes rough, scaly skin patches. Left untreated, AK can lead to a skin cancer called squamous cell carcinoma. […] If you notice new red or rough bumps on your skin, call your healthcare provider for diagnosis and treatment. […] Actinic keratosis (AK) is a skin disorder that causes rough, scaly patches of skin. Another name for AK is solar keratosis. […] Without treatment, AK can lead to a type of skin cancer called squamous cell carcinoma. […] Your primary care provider, a dermatologist, (provider specializing in skin conditions) or other healthcare provider can often diagnose actinic keratosis by carefully examining your skin and using magnification. […] If your healthcare provider is uncertain or the skin looks unusual, she/ he may recommend a skin biopsy.

• #5 Actinic Keratoses – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/sunlight-and-skin-damage/actinic-keratoses

  Actinic keratoses (solar keratoses) are precancerous growths caused by long-term sun exposure. […] The diagnosis is usually based on a doctor’s evaluation. […] Doctors diagnose actinic keratoses by looking at and touching them. Because of their rough texture, actinic keratoses are often easier to feel than see. […] If a person is not helped by any of these treatments, doctors may do a biopsy to rule out squamous cell carcinoma.

• #6 Actinic keratosis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/actinic-keratosis/symptoms-causes/syc-20354969

  An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on the skin that develops from years of sun exposure. It’s often found on the face, lips, ears, forearms, scalp, neck or back of the hands. […] Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. […] Also known as a solar keratosis, an actinic keratosis grows slowly and usually first appears in people over 40. […] It can be difficult to distinguish between noncancerous spots and cancerous ones. So it’s best to have new skin changes evaluated by a health care provider especially if a scaly spot or patch persists, grows or bleeds. […] An actinic keratosis is caused by frequent or intense exposure to ultraviolet (UV) rays from the sun or tanning beds. […] If treated early, actinic keratosis can be cleared up or removed. If left untreated, some of these spots might progress to squamous cell carcinoma. This is a type of cancer that usually isn’t life-threatening if detected and treated early.

• #7 Actinic keratoses – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/actinic-keratoses/

  Actinic keratoses are areas of sun-damaged skin. They usually occur on parts of the body that are exposed to the sun. This includes the forearms, back of the hands, face, ears, and any scalp areas without hair (e.g., as a result of balding). They may also occur on the lips. […] Actinic keratoses are caused by sun exposure over many years. This includes sunbathing, sunbed use, outdoor work, or recreational activities, and living in a country with a sunny climate. […] Actinic keratoses can be variable in appearance. They may simply feel rough or scaly, looking like dry skin. They are often pink but can be skin-coloured or red. […] If left untreated for many years, there is a very small risk that an actinic keratosis can progress into a form of skin cancer called a squamous cell carcinoma.

• #8 Actinic Keratosis (AK): Causes, Symptoms, and Treatment

  https://patient.info/doctor/actinic-keratosis-pro

  Actinic keratosis diagnosis is usually clinical, ideally with the help of a dermatoscope. Confocal laser microscopy and optical coherence tomography can also help in diagnosis. Skin biopsy is used where there are features which are high risk for malignant change. […] Diagnosis of actinic keratosis is usually clinical, ideally with the help of a dermatoscope. […] Clinical classification of individual lesions is as follows: Grade 1: slightly palpable (better felt than seen). Grade 2: moderately thick (easily felt and seen). Grade 3: very thick, hyperkeratotic and/or obvious. […] Many cases can be managed in primary care by a GP with special interest (GPwSI). […] Refer through the two-week suspected cancer pathway if there are features suspicious of SCC: Recent growth/tenderness/inflammation. A nodular lesion. Bleeding/ulceration. Lesions on the lips.

• #9 SciELO Brazil – Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects^, Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects^,

  https://www.scielo.br/j/abd/a/KNfmyRfzPpytwPWZnTrK8Br/

  Actinic keratoses are diagnosed clinically in the majority of the cases. Lesions presenting compatible history data and physical examinations may be recognized and do not need complementary analyses. Dermoscopy has been shown to be extremely important in increasing the level of confidence and accuracy in equivocal lesions. […] Dermoscopy has high sensitivity and specificity for the diagnosis of actinic keratoses, with values of 98.7% and 95%, respectively.

• #10 Actinic Keratosis (Solar Keratosis) – The Skin Cancer Doctor

  https://www.theskincancerdoctor.com.au/education/skincancerlesions/actinic-keratosis-solar-keratosis/

  Actinic keratosis (AK) is also known as solar keratosis. This is a premalignant lesion that results from the proliferation of atypical epidermal keratinocytes. The importance for identifying actinic keratosis is because they represent early lesions on a continuum with skin squamous cell carcinoma (SCC). Therefore, if untreated, they may progress to cutaneous squamous cell carcinoma. […] Actinic keratosis are usually diagnosed clinically via physical examination include touch and inspection. When there is suspicion for malignancy, a biopsy is typically done. […] Clinical differentiation between pigmented AKs and lentigo maligna can be challenging. Dermatoscopy may not be reliable for distinguishing between these lesions and histopathologic examination remains the gold standard for such cases.

• #11 Actinic keratosis dermoscopy

  https://dermnetnz.org/topics/actinic-keratosis-dermoscopy

  Actinic keratosis is a scaly lesion found on sun-damaged skin. It is considered precancerous because a cutaneous squamous cell carcinoma may arise from actinic keratosis. Actinic keratosis is also known as AK and solar keratosis. […] Actinic keratosis is diagnosed by a combination of clinical and dermoscopic features and sometimes can be difficult to distinguish from other lesions. It may coexist with solar lentigo, cutaneous squamous cell carcinoma, and lentigo maligna. […] Cutaneous squamous cell carcinoma can arise from actinic keratosis. Differentiation is determined by dermoscopic findings of peripheral white around a central scaly core (the original actinic keratosis). […] Dotted/coiled vessels tend to be scattered more randomly in actinic keratosis than in intraepidermal carcinoma where they are arranged in lines or clusters. Vascular structures in squamous cell carcinoma in situ show greater variation in size and structure. […] The following four features are significantly associated with lentigo maligna: hyperpigmented follicular openings, obliterated follicular openings, annular-granular structures, and pigmented rhomboids. […] The correlation between histological and dermoscopic features of actinic keratosis is poor.

• #12 Actinic keratosis – dermoscopedia

  https://dermoscopedia.org/Actinic_keratosis

  Actinic keratoses (AKs) typically arise on chronically sun-damaged skin and represent the most common lesions in the spectrum of keratinocyte skin cancer. Clinically they present as multiple pink macules or papules with a variably scaly surface. […] Nonpigmented AK on the face show four dermoscopic features, allowing an accurate diagnosis with high sensitivity and specificity: […] An additional clue to the diagnosis of AK is the rosette sign, which can only be seen with polarized light and consists of a white four-leaf clover-shaped structure. […] The discrimination between benign pAK and pigmented tumors such as Lentigo maligna (LM) may be challenging, due to the dermoscopic overlapping morphological features. […] The dermoscopic differential diagnosis of pAK is supported by the presence of a prominent pseudonetwork located between keratin-filled ostial openings. […] The dermoscopy may help guide the best location to biopsy. Biopsying areas which reveal the most suspicious features, such as annular granular structures, asymmetric follicular openings, dots within the ostial openings, or rhomboidal structures may provide an accurate histologic diagnosis.

• #13 Actinic Keratosis (Solar Keratosis) – The Skin Cancer Doctor

  https://www.theskincancerdoctor.com.au/education/skincancerlesions/actinic-keratosis-solar-keratosis/

  Actinic keratosis (AK) is also known as solar keratosis. This is a premalignant lesion that results from the proliferation of atypical epidermal keratinocytes. The importance for identifying actinic keratosis is because they represent early lesions on a continuum with skin squamous cell carcinoma (SCC). Therefore, if untreated, they may progress to cutaneous squamous cell carcinoma. […] Actinic keratosis are usually diagnosed clinically via physical examination include touch and inspection. When there is suspicion for malignancy, a biopsy is typically done. […] Clinical differentiation between pigmented AKs and lentigo maligna can be challenging. Dermatoscopy may not be reliable for distinguishing between these lesions and histopathologic examination remains the gold standard for such cases.

• #14 Actinic keratosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/actinic-keratosis/diagnosis-treatment/drc-20354975

  Your health care provider will likely be able to determine whether you have an actinic keratosis simply by looking at your skin. If there’s any doubt, your health care provider may do other tests, such as a skin biopsy. During a skin biopsy, a small sample of skin is taken for analysis in a lab. A biopsy can usually be done in a clinic after a numbing injection. […] Even after treatment for actinic keratosis, your health care provider might suggest that you have your skin checked at least once a year for signs of skin cancer.

• #15 Actinic Keratosis: Risk Factors, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14148-actinic-keratosis

  Actinic keratosis (AK) causes rough, scaly skin patches. Left untreated, AK can lead to a skin cancer called squamous cell carcinoma. […] If you notice new red or rough bumps on your skin, call your healthcare provider for diagnosis and treatment. […] Actinic keratosis (AK) is a skin disorder that causes rough, scaly patches of skin. Another name for AK is solar keratosis. […] Without treatment, AK can lead to a type of skin cancer called squamous cell carcinoma. […] Your primary care provider, a dermatologist, (provider specializing in skin conditions) or other healthcare provider can often diagnose actinic keratosis by carefully examining your skin and using magnification. […] If your healthcare provider is uncertain or the skin looks unusual, she/ he may recommend a skin biopsy.

• #16 Actinic Keratosis Symptoms and Treatment Options | SJPP

  https://www.sjpp.org/dermatology/conditions/bumps-spots/actinic-keratosis/

  Also known as solar keratosis, actinic keratosis is a prevalent skin condition with over 3 million new cases each year in the United States. […] Diagnosis of actinic keratosis begins with an examination of your skin. Your doctor may ask you questions, such as when you first noticed it and if it has changed. Most often, an actinic keratosis is diagnosed based on a clinical exam. However, sometimes your doctor may order additional tests, such as a skin biopsy. Before the biopsy, the doctor will numb the area where they will take a small sample of your skin to analyze under a microscope.

• #17 SciELO Brazil – Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects^, Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects^,

  https://www.scielo.br/j/abd/a/KNfmyRfzPpytwPWZnTrK8Br/

  Actinic keratoses are dysplastic proliferations of keratinocytes with potential for malignant transformation. Clinically, actinic keratoses present as macules, papules, or hyperkeratotic plaques with an erythematous background that occur on photoexposed areas. […] Diagnosis of lesions is based on clinical and dermoscopic examination, but in some situations histopathological analysis may be necessary. […] The diagnosis of actinic keratoses is based on clinical examination, in some cases a skin biopsy is necessary; these are the major criteria for biopsies: large lesions (1 cm in diameter), bleeding, ulceration or induration, rapid lesional growth and erythema. […] Although the diagnosis of actinic keratoses is based on clinical examination, in some cases a skin biopsy is necessary; these are the major criteria for biopsies: large lesions (1 cm in diameter), bleeding, ulceration or induration, rapid lesional growth and erythema.

• #18 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  The majority can be managed in general practice. The following groups should be referred: To a GPwER / accredited GPwSI, or a dermatologist. Diagnostic uncertainty. Patients with more widespread / severe actinic damage. If an SCC is suspected refer to Secondary Care as urgent (2-week wait). The following could suggest transformation from an AK into an SCC: History – recent growth / pain / bleeding. Examination – an elevated lesion (if significant surface scale, remove to see if there is a palpable lump underneath), ulceration, induration, tenderness, surrounding inflammation. Beware lesions on lips – SCC can be very subtle at this site. Have a low threshold for referring immunosuppressed patients (in particular post-transplant) who are at high risk of developing SCC that tend to metastasise quicker. Very young patients presenting with AK – consider xeroderma pigmentosum.

• #19 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  An actinic keratosis (AK) is a common sun-induced scaly or hyperkeratotic lesion, which has the potential to become malignant. NICE estimates that over 23% of the UK population aged 60 and above have AK. Although the risk of an AK transforming into a squamous cell carcinoma (SCC) is very low, this risk increases over time and with larger numbers of lesions. The presence of ten AK is associated with a 14% risk of developing an SCC within five years. […] Diagnosis is usually clinical. If a diagnostic biopsy is required the primary histologic feature is partial thickness atypia / dysplasia of the keratinocytes in the basal layers of the epidermis. This is often accompanied by parakeratosis, thinning of the granular layer, buds of atypical epidermis extending toward the papillary dermis, dermal solar elastosis, and inflammation. If squamous cell carcinoma is a differential the patient must be referred urgently to Secondary Care without a biopsy.

• #20 Actinic Keratosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1099775-overview

  Actinic keratosis (AK) is an ultraviolet (UV) lightinduced skin lesion that may progress to invasive squamous cell carcinoma (SCC). It is by far the most common lesion with malignant potential to arise on the skin. Actinic keratosis is seen in fair-skinned persons on skin areas that have had long-term sun exposure. […] In the United States, actinic keratosis represents the second most frequent reason for patients to visit a dermatologist. […] A skin biopsy is indicated to confirm the diagnosis and to rule out invasive SCC for suspicious or more advanced lesions (ie, those with more pronounced hyperkeratosis, increased erythema, or induration or nodularity). […] Actinic keratosis is characterized by dysplasia and architectural disorder of the epidermis, as follows: abnormal keratinocytes of the basal layer that are variable in size and shape, altered cellular polarity, nuclear atypia, hyperkeratosis and parakeratosis of the epidermis, and irregular acanthosis may be present.

• #21 Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care

  https://www.mdpi.com/2072-6694/16/3/484

  Actinic keratosis (AK), also known as solar keratosis, is a keratinocyte-derived precancerous lesion frequently found in adults, that typically develops on parts of the skin exposed to the sun. […] The primary risk factors for AK and field cancerization (FIC) development include long-term ultraviolet radiation exposure, sunbed usage, being over 60 years of age, male gender, light skin types, extended periods of immunosuppression, and a past occurrence of AK or non-melanoma skin cancer. […] The need for early diagnosis and treatment of AK is more and more important as a consequence of continuously increasing economic impact as the global population ages and accumulates lifetime sun exposure. […] Dermoscopy, High Frequency Ultrasonography (HFUS), Dermoscopy-Guided High-Frequency Ultrasound (DG-HFUS), Optical Coherence Tomography (OCT), and Reflectance Confocal Microscopy (RCM) are the most frequently used non-invasive techniques for the evaluation, treatment, and monitoring of precancerous and cancerous lesions.

• #22 Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care

  https://www.mdpi.com/2072-6694/16/3/484

  Non-invasive imaging methods allow not only the easy identification of field cancerization, sometimes even in the precancerous stages or even before the appearance of AK, but also open the possibility of an efficient and non-invasive therapeutic follow-up method. […] RCM is an efficient, non-invasive, and rapidly performing method of assessing the degree of AK and FIC, allowing the dermatologist to evaluate the effectiveness of topical therapies in the absence of tissue sampling. […] Current studies show promising results for RCM diagnostic accuracy, with sensitivities and sensibilities ranging from 79–100% and 78–100%, respectively, in diagnosing AK, SCC in situ, and SCC.

• #23 Actinic Keratosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/1099775-overview

  Fluorescence with the use of a photosensitizing drug (methyl ester of 5-aminolevulinic acid [ALA], a precursor of protoporphyrin) commonly used in photodynamic therapy (PDT) has been described as a diagnostic tool for actinic keratosis. […] Most actinic keratoses do not progress to invasive squamous cell carcinoma; however, most invasive squamous cell carcinomas have evidence of a preexisting actinic keratosis. […] Development into invasive squamous cell carcinomas can be prevented by aggressive therapy and sun protection.

• #24 Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care

  https://www.mdpi.com/2072-6694/16/3/484

  Non-invasive imaging methods allow not only the easy identification of field cancerization, sometimes even in the precancerous stages or even before the appearance of AK, but also open the possibility of an efficient and non-invasive therapeutic follow-up method. […] RCM is an efficient, non-invasive, and rapidly performing method of assessing the degree of AK and FIC, allowing the dermatologist to evaluate the effectiveness of topical therapies in the absence of tissue sampling. […] Current studies show promising results for RCM diagnostic accuracy, with sensitivities and sensibilities ranging from 79–100% and 78–100%, respectively, in diagnosing AK, SCC in situ, and SCC.

• #25 Actinic Keratoses – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/reactions-to-sunlight/actinic-keratoses

  Actinic keratoses are precancerous changes in skin cells (keratinocytes) that are a frequent consequence of many years of sun exposure. Diagnosis is clinical. […] Diagnosis of actinic keratoses is often based on visual and tactile examination; lesions feel rough and scaly on palpation. […] An actinic keratosis can also be distinguished from a seborrheic keratosis by the rough, gritty feel of the scale and the erythema. […] If patients do not respond to therapy, clinicians should consider doing a biopsy to rule out squamous cell carcinoma.

• #26 Actinic keratosis dermoscopy

  https://dermnetnz.org/topics/actinic-keratosis-dermoscopy

  Actinic keratosis is a scaly lesion found on sun-damaged skin. It is considered precancerous because a cutaneous squamous cell carcinoma may arise from actinic keratosis. Actinic keratosis is also known as AK and solar keratosis. […] Actinic keratosis is diagnosed by a combination of clinical and dermoscopic features and sometimes can be difficult to distinguish from other lesions. It may coexist with solar lentigo, cutaneous squamous cell carcinoma, and lentigo maligna. […] Cutaneous squamous cell carcinoma can arise from actinic keratosis. Differentiation is determined by dermoscopic findings of peripheral white around a central scaly core (the original actinic keratosis). […] Dotted/coiled vessels tend to be scattered more randomly in actinic keratosis than in intraepidermal carcinoma where they are arranged in lines or clusters. Vascular structures in squamous cell carcinoma in situ show greater variation in size and structure. […] The following four features are significantly associated with lentigo maligna: hyperpigmented follicular openings, obliterated follicular openings, annular-granular structures, and pigmented rhomboids. […] The correlation between histological and dermoscopic features of actinic keratosis is poor.

• #27 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  The majority can be managed in general practice. The following groups should be referred: To a GPwER / accredited GPwSI, or a dermatologist. Diagnostic uncertainty. Patients with more widespread / severe actinic damage. If an SCC is suspected refer to Secondary Care as urgent (2-week wait). The following could suggest transformation from an AK into an SCC: History – recent growth / pain / bleeding. Examination – an elevated lesion (if significant surface scale, remove to see if there is a palpable lump underneath), ulceration, induration, tenderness, surrounding inflammation. Beware lesions on lips – SCC can be very subtle at this site. Have a low threshold for referring immunosuppressed patients (in particular post-transplant) who are at high risk of developing SCC that tend to metastasise quicker. Very young patients presenting with AK – consider xeroderma pigmentosum.

• #28 Actinic Keratoses – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/reactions-to-sunlight/actinic-keratoses

  Actinic keratoses are precancerous changes in skin cells (keratinocytes) that are a frequent consequence of many years of sun exposure. Diagnosis is clinical. […] Diagnosis of actinic keratoses is often based on visual and tactile examination; lesions feel rough and scaly on palpation. […] An actinic keratosis can also be distinguished from a seborrheic keratosis by the rough, gritty feel of the scale and the erythema. […] If patients do not respond to therapy, clinicians should consider doing a biopsy to rule out squamous cell carcinoma.

• #29 Actinic keratosis dermoscopy

  https://dermnetnz.org/topics/actinic-keratosis-dermoscopy

  Actinic keratosis is a scaly lesion found on sun-damaged skin. It is considered precancerous because a cutaneous squamous cell carcinoma may arise from actinic keratosis. Actinic keratosis is also known as AK and solar keratosis. […] Actinic keratosis is diagnosed by a combination of clinical and dermoscopic features and sometimes can be difficult to distinguish from other lesions. It may coexist with solar lentigo, cutaneous squamous cell carcinoma, and lentigo maligna. […] Cutaneous squamous cell carcinoma can arise from actinic keratosis. Differentiation is determined by dermoscopic findings of peripheral white around a central scaly core (the original actinic keratosis). […] Dotted/coiled vessels tend to be scattered more randomly in actinic keratosis than in intraepidermal carcinoma where they are arranged in lines or clusters. Vascular structures in squamous cell carcinoma in situ show greater variation in size and structure. […] The following four features are significantly associated with lentigo maligna: hyperpigmented follicular openings, obliterated follicular openings, annular-granular structures, and pigmented rhomboids. […] The correlation between histological and dermoscopic features of actinic keratosis is poor.

• #30 Actinic keratoses (Solar keratosis): Diagnosis and Treatment — DermNet

  https://dermnetnz.org/topics/actinic-keratosis

  Actinic keratosis is a precancerous scaly spot found on sun-damaged skin, also known as solar keratosis. It may be considered an early form of cutaneous squamous cell carcinoma (a keratinocyte cancer). […] Actinic keratosis is usually easy to diagnose clinically or by dermoscopy. Occasionally, a biopsy is necessary, for example, to exclude SCC, or if treatment fails. […] The main concern is that actinic keratoses indicate an increased risk of developing cutaneous squamous cell carcinoma. It is rare for a solitary actinic keratosis to evolve to squamous cell carcinoma (SCC), but the risk of SCC occurring at some stage in a patient with more than 10 actinic keratoses is thought to be about 10 to 15%. […] Actinic keratoses are prevented by strict sun protection. If already present, actinic keratoses may improve with a very high sun protection factor (50+) broad-spectrum sunscreen applied at least daily to affected areas, year-round.

• #31

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6939186/

  The diagnosis of actinic keratoses is based on clinical examination, in some cases a skin biopsy is necessary. […] Actinic keratoses may follow three different paths, the most relevant being the transformation into SCC. […] Data about the risk of malignant transformation of a single actinic keratosis ranges from 0.1% to 16%. […] According to some authors, 60-80% of SCCs develop in areas of actinic keratoses. […] The evolution of actinic keratoses varies according to patient’s clinical characteristics.

• #32 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  An actinic keratosis (AK) is a common sun-induced scaly or hyperkeratotic lesion, which has the potential to become malignant. NICE estimates that over 23% of the UK population aged 60 and above have AK. Although the risk of an AK transforming into a squamous cell carcinoma (SCC) is very low, this risk increases over time and with larger numbers of lesions. The presence of ten AK is associated with a 14% risk of developing an SCC within five years. […] Diagnosis is usually clinical. If a diagnostic biopsy is required the primary histologic feature is partial thickness atypia / dysplasia of the keratinocytes in the basal layers of the epidermis. This is often accompanied by parakeratosis, thinning of the granular layer, buds of atypical epidermis extending toward the papillary dermis, dermal solar elastosis, and inflammation. If squamous cell carcinoma is a differential the patient must be referred urgently to Secondary Care without a biopsy.

• #33 Actinic Keratosis

  https://www.skincancer.net.au/actinic-keratosis

  Actinic Keratosis, also known as a solar keratosis, is a pre-cancerous form of Squamous Cell Carcinoma of the skin arising from the flat (squamous) cells in the uppermost layers of the skin known as the epidermis. […] Often Actinic Keratoses are so small that they can only be detected by expert examination. […] Studies state that up to 20% can progress to become Squamous Cell Carcinoma or other skin cancers. […] When treated early the vast majority of Actinic Keratosis are not serious and their significance lies in their potential to transform, and in cases of heavy encrustation, to cause cosmetic impact that in severe cases can be significant. […] Although the vast majority of Actinic Keratoses remain benign, some studies report that up to twenty percent can progress and become Squamous Cell Carcinoma.

• #34 Actinic Keratosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557401/

  While there are various treatment options for actinic keratoses, no treatment option is without risks. […] Actinic keratosis treatments may have potential adverse effects such as pain, inflammation, healing issues, pigment changes, and scarring. […] Patients diagnosed with actinic keratosis should undergo regular skin cancer screening. […] A variety of lesion-directed and field-directed treatment options are available for actinic keratosis. […] Long-term follow-up of actinic keratosis is required to monitor for new lesions, recurrences, and progression to malignancy.

• #35 Actinic keratosis: Diagnosis and treatment

  https://www.aad.org/public/diseases/skin-cancer/actinic-keratosis-treatment

  Some people develop a few AKs, which can often be cleared with treatment. […] If you have many AKs, its a good idea to be under a dermatologists care. […] Your dermatologist can watch for signs of new AKs and skin cancer. […] Your dermatologist will tell you how often to return for check-ups. […] Keep every appointment. If skin cancer develops, the sooner it is found and treated, the better your outcome. […] The right self-care can help to prevent new AKs and skin cancer.

• #36 Actinic keratoses (Solar keratosis): Diagnosis and Treatment — DermNet

  https://dermnetnz.org/topics/actinic-keratosis

  Actinic keratoses may recur months or years after treatment. The same treatment can be repeated or another method used. Patients who have been treated for actinic keratoses are at risk of developing new keratoses. They are also at increased risk of other skin cancers, especially intraepidermal squamous cell carcinoma, invasive cutaneous squamous cell carcinoma, basal cell carcinoma and melanoma.

• #37 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  The majority can be managed in general practice. The following groups should be referred: To a GPwER / accredited GPwSI, or a dermatologist. Diagnostic uncertainty. Patients with more widespread / severe actinic damage. If an SCC is suspected refer to Secondary Care as urgent (2-week wait). The following could suggest transformation from an AK into an SCC: History – recent growth / pain / bleeding. Examination – an elevated lesion (if significant surface scale, remove to see if there is a palpable lump underneath), ulceration, induration, tenderness, surrounding inflammation. Beware lesions on lips – SCC can be very subtle at this site. Have a low threshold for referring immunosuppressed patients (in particular post-transplant) who are at high risk of developing SCC that tend to metastasise quicker. Very young patients presenting with AK – consider xeroderma pigmentosum.

• #38 Actinic keratosis: Diagnosis and treatment

  https://www.aad.org/public/diseases/skin-cancer/actinic-keratosis-treatment

  Some people develop a few AKs, which can often be cleared with treatment. […] If you have many AKs, its a good idea to be under a dermatologists care. […] Your dermatologist can watch for signs of new AKs and skin cancer. […] Your dermatologist will tell you how often to return for check-ups. […] Keep every appointment. If skin cancer develops, the sooner it is found and treated, the better your outcome. […] The right self-care can help to prevent new AKs and skin cancer.

• #39 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  The majority can be managed in general practice. The following groups should be referred: To a GPwER / accredited GPwSI, or a dermatologist. Diagnostic uncertainty. Patients with more widespread / severe actinic damage. If an SCC is suspected refer to Secondary Care as urgent (2-week wait). The following could suggest transformation from an AK into an SCC: History – recent growth / pain / bleeding. Examination – an elevated lesion (if significant surface scale, remove to see if there is a palpable lump underneath), ulceration, induration, tenderness, surrounding inflammation. Beware lesions on lips – SCC can be very subtle at this site. Have a low threshold for referring immunosuppressed patients (in particular post-transplant) who are at high risk of developing SCC that tend to metastasise quicker. Very young patients presenting with AK – consider xeroderma pigmentosum.

• #40 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  The majority can be managed in general practice. The following groups should be referred: To a GPwER / accredited GPwSI, or a dermatologist. Diagnostic uncertainty. Patients with more widespread / severe actinic damage. If an SCC is suspected refer to Secondary Care as urgent (2-week wait). The following could suggest transformation from an AK into an SCC: History – recent growth / pain / bleeding. Examination – an elevated lesion (if significant surface scale, remove to see if there is a palpable lump underneath), ulceration, induration, tenderness, surrounding inflammation. Beware lesions on lips – SCC can be very subtle at this site. Have a low threshold for referring immunosuppressed patients (in particular post-transplant) who are at high risk of developing SCC that tend to metastasise quicker. Very young patients presenting with AK – consider xeroderma pigmentosum.

• #41 Actinic keratosis, solar keratosis

  https://www.pcds.org.uk/clinical-guidance/actinic-keratosis-syn-solar-keratosis

  The majority can be managed in general practice. The following groups should be referred: To a GPwER / accredited GPwSI, or a dermatologist. Diagnostic uncertainty. Patients with more widespread / severe actinic damage. If an SCC is suspected refer to Secondary Care as urgent (2-week wait). The following could suggest transformation from an AK into an SCC: History – recent growth / pain / bleeding. Examination – an elevated lesion (if significant surface scale, remove to see if there is a palpable lump underneath), ulceration, induration, tenderness, surrounding inflammation. Beware lesions on lips – SCC can be very subtle at this site. Have a low threshold for referring immunosuppressed patients (in particular post-transplant) who are at high risk of developing SCC that tend to metastasise quicker. Very young patients presenting with AK – consider xeroderma pigmentosum.

• #42 Actinic Keratosis (AK): Causes, Symptoms, and Treatment

  https://patient.info/doctor/actinic-keratosis-pro

  Actinic keratosis diagnosis is usually clinical, ideally with the help of a dermatoscope. Confocal laser microscopy and optical coherence tomography can also help in diagnosis. Skin biopsy is used where there are features which are high risk for malignant change. […] Diagnosis of actinic keratosis is usually clinical, ideally with the help of a dermatoscope. […] Clinical classification of individual lesions is as follows: Grade 1: slightly palpable (better felt than seen). Grade 2: moderately thick (easily felt and seen). Grade 3: very thick, hyperkeratotic and/or obvious. […] Many cases can be managed in primary care by a GP with special interest (GPwSI). […] Refer through the two-week suspected cancer pathway if there are features suspicious of SCC: Recent growth/tenderness/inflammation. A nodular lesion. Bleeding/ulceration. Lesions on the lips.

• #43 Actinic Keratosis (Solar Keratosis) Condition, Treatments and Pictures for Adults – Skinsight

  https://skinsight.com/skin-conditions/actinic-keratosis-solar-keratosis/

  Actinic keratoses, also known as solar keratoses, are small rough, scaly, slightly raised areas of skin (papules) that usually occur in body locations that have been chronically exposed to the sun. Actinic keratoses are precancerous, each having a less than 1% chance of turning into a skin cancer (squamous cell skin cancer). Because of this risk, it is important to perform self-examinations regularly and get them treated by a medical professional early. […] Actinic keratoses usually appear in those who are older than 50, but they can start appearing in younger adults who have had a lot of sun exposure. […] Actinic keratoses are rough, scaly, slightly raised papules on sun-damaged skin. […] Perform a self-exam regularly to look for signs of skin cancer. […] If you have a new skin growth or an existing lesion that is growing or bleeding, see your medical professional. […] Depending on how many actinic keratoses you have, your medical professional will tailor treatment, which may include: Removal with freezing (cryosurgery), scraping (curettage), or burning (electrocautery).

• #44 Actinic Keratosis Warning Signs and Images

  https://www.skincancer.org/skin-cancer-information/actinic-keratosis/actinic-keratosis-warning-signs-and-images/

  Detecting an actinic keratosis (AK) early gives you the opportunity to treat the lesion and prevent skin cancer before it starts. When diagnosed promptly, almost all actinic keratoses (plural) can be successfully removed. Left untreated, some AKs may progress to squamous cell carcinoma (SCC). […] If you have a history of unprotected UV exposure, live in a sunny location or have other risk factors, be on the lookout for any unusual changes in your skin. […] See your dermatologist every year for a professional skin exam. Having a specialist who is skilled at identifying and treating abnormal skin growths is vital to your health and wellness. Anyone who has AKs should be under a dermatologist’s care.

• #45 Actinic keratosis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/actinic-keratosis/symptoms-causes/syc-20354969

  An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on the skin that develops from years of sun exposure. It’s often found on the face, lips, ears, forearms, scalp, neck or back of the hands. […] Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface. […] Also known as a solar keratosis, an actinic keratosis grows slowly and usually first appears in people over 40. […] It can be difficult to distinguish between noncancerous spots and cancerous ones. So it’s best to have new skin changes evaluated by a health care provider especially if a scaly spot or patch persists, grows or bleeds. […] An actinic keratosis is caused by frequent or intense exposure to ultraviolet (UV) rays from the sun or tanning beds. […] If treated early, actinic keratosis can be cleared up or removed. If left untreated, some of these spots might progress to squamous cell carcinoma. This is a type of cancer that usually isn’t life-threatening if detected and treated early.

• #46 Actinic keratoses (solar keratoses)

  https://www.nhs.uk/conditions/actinic-keratoses/

  Actinic keratoses (also called solar keratoses) are dry, scaly patches of skin that have been damaged by the sun. It’s not usually serious, but there’s a small chance the patches could become skin cancer. Protecting your skin in the sun and watching out for changes can help. […] Actinic keratoses patches: can feel dry, rough and scaly, or like sandpaper; are usually between 1cm and 2cm in size; can be the same colour as your skin, or range from pink to red to brown; may be itchy. […] The patches usually appear on areas of your body that are often exposed to the sun, such as your face, hands and arms, ears, scalp and legs. […] It’s important to get these skin changes checked in case they’re being caused by something more serious, such as skin cancer. […] Treatments for actinic keratoses include: prescription creams and gels; freezing the patches (cryotherapy) this makes the patches turn into blisters and fall off after a few weeks; surgery to cut out or scrape away the patches you’ll be given a local anaesthetic first, so it does not hurt; photodynamic therapy (PDT), where special cream is applied to the patches and a light is shone on them.

• #47 Actinic Keratosis: Risk Factors, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14148-actinic-keratosis

  Most actinic keratoses (AKs) go away with treatment. […] If you think you have an AK, it’s important to see your healthcare provider right away. […] Actinic keratosis is a serious skin disorder that requires immediate treatment. […] You can lower your risk of actinic keratosis by protecting your skin from sun exposure and ultraviolet light. […] If you think you have AK, speak with your healthcare provider about diagnosis and treatment.

• #48 Actinic keratosis: Diagnosis and treatment

  https://www.aad.org/public/diseases/skin-cancer/actinic-keratosis-treatment

  Some people develop a few AKs, which can often be cleared with treatment. […] If you have many AKs, its a good idea to be under a dermatologists care. […] Your dermatologist can watch for signs of new AKs and skin cancer. […] Your dermatologist will tell you how often to return for check-ups. […] Keep every appointment. If skin cancer develops, the sooner it is found and treated, the better your outcome. […] The right self-care can help to prevent new AKs and skin cancer.

• #49 Actinic keratosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/actinic-keratosis/diagnosis-treatment/drc-20354975

  Your health care provider will likely be able to determine whether you have an actinic keratosis simply by looking at your skin. If there’s any doubt, your health care provider may do other tests, such as a skin biopsy. During a skin biopsy, a small sample of skin is taken for analysis in a lab. A biopsy can usually be done in a clinic after a numbing injection. […] Even after treatment for actinic keratosis, your health care provider might suggest that you have your skin checked at least once a year for signs of skin cancer.

• #50 Actinic keratoses (Solar keratosis): Diagnosis and Treatment — DermNet

  https://dermnetnz.org/topics/actinic-keratosis

  Actinic keratosis is a precancerous scaly spot found on sun-damaged skin, also known as solar keratosis. It may be considered an early form of cutaneous squamous cell carcinoma (a keratinocyte cancer). […] Actinic keratosis is usually easy to diagnose clinically or by dermoscopy. Occasionally, a biopsy is necessary, for example, to exclude SCC, or if treatment fails. […] The main concern is that actinic keratoses indicate an increased risk of developing cutaneous squamous cell carcinoma. It is rare for a solitary actinic keratosis to evolve to squamous cell carcinoma (SCC), but the risk of SCC occurring at some stage in a patient with more than 10 actinic keratoses is thought to be about 10 to 15%. […] Actinic keratoses are prevented by strict sun protection. If already present, actinic keratoses may improve with a very high sun protection factor (50+) broad-spectrum sunscreen applied at least daily to affected areas, year-round.

• #51 Actinic keratosis: Diagnosis and treatment

  https://www.aad.org/public/diseases/skin-cancer/actinic-keratosis-treatment

  Some people develop a few AKs, which can often be cleared with treatment. […] If you have many AKs, its a good idea to be under a dermatologists care. […] Your dermatologist can watch for signs of new AKs and skin cancer. […] Your dermatologist will tell you how often to return for check-ups. […] Keep every appointment. If skin cancer develops, the sooner it is found and treated, the better your outcome. […] The right self-care can help to prevent new AKs and skin cancer.

• #52 Actinic keratoses (Solar keratosis): Diagnosis and Treatment — DermNet

  https://dermnetnz.org/topics/actinic-keratosis

  Actinic keratoses may recur months or years after treatment. The same treatment can be repeated or another method used. Patients who have been treated for actinic keratoses are at risk of developing new keratoses. They are also at increased risk of other skin cancers, especially intraepidermal squamous cell carcinoma, invasive cutaneous squamous cell carcinoma, basal cell carcinoma and melanoma.

• #53 Actinic Keratosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557401/

  While there are various treatment options for actinic keratoses, no treatment option is without risks. […] Actinic keratosis treatments may have potential adverse effects such as pain, inflammation, healing issues, pigment changes, and scarring. […] Patients diagnosed with actinic keratosis should undergo regular skin cancer screening. […] A variety of lesion-directed and field-directed treatment options are available for actinic keratosis. […] Long-term follow-up of actinic keratosis is required to monitor for new lesions, recurrences, and progression to malignancy.

• #54 SciELO Brazil – Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects^, Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects^,

  https://www.scielo.br/j/abd/a/KNfmyRfzPpytwPWZnTrK8Br/

  Actinic keratoses are diagnosed clinically in the majority of the cases. Lesions presenting compatible history data and physical examinations may be recognized and do not need complementary analyses. Dermoscopy has been shown to be extremely important in increasing the level of confidence and accuracy in equivocal lesions. […] Dermoscopy has high sensitivity and specificity for the diagnosis of actinic keratoses, with values of 98.7% and 95%, respectively.

• #55 Actinic keratosis: Epidemiology, clinical features, and diagnosis – UpToDate

  https://www.uptodate.com/contents/actinic-keratosis-epidemiology-clinical-features-and-diagnosis

  Actinic keratosis (AK; also known as solar keratosis) is a cutaneous lesion that results from the proliferation of atypical epidermal keratinocytes. AK represent early lesions on a continuum with squamous cell carcinoma (SCC) and occasionally progress to SCC. […] The epidemiology, clinical features, natural history, and diagnosis of AK will be discussed here. […] DIAGNOSIS: Clinical examination, Dermoscopy, Biopsy, Pathology.

• #56 Actinic keratosis: Causes and prevention

  https://www.medicalnewstoday.com/articles/318466

  Actinic keratosis is a precancerous growth on the skin that forms due to long-term exposure to UV light. It is also known as solar keratosis. […] As a result, it is essential for doctors to monitor for actinic keratosis and treat it where appropriate. […] A doctor or dermatologist is likely to be able to diagnose actinic keratosis with a simple visual examination. They may order a skin biopsy and send a sample for laboratory testing if necessary. […] The earlier a healthcare professional can diagnose and treat actinic keratosis, the lower the risk of skin cancer. […] Early diagnosis and treatment of actinic keratoses can prevent them from developing into skin cancer.

• #57 Actinic Keratosis (AK): Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/cancer/actinic-keratosis/

  Actinic keratosis (AK), also called solar keratosis, is a skin lesion thats caused by ultraviolet (UV) damage. If you develop more than one actinic keratosis lesion, you are said to have actinic keratoses (AKs; plural). If you dont treat AKs, they can turn into a type of skin cancer called squamous cell carcinoma. But only about 5 to 10 percent of AKs will turn into cancer. Most of the time, an AK goes away with treatment, but since doctors dont know which AKs will turn into skin cancer, its important to treat them all. […] Most of the time, doctors can diagnose an AK by visually examining and feeling the lesion. If they are unsure whether the spot is an AK, they may perform a skin biopsy. This involves cutting out a small piece of tissue and sending it to a lab to be examined under a microscope. Results of the biopsy can confirm a diagnosis. A dermatologist (a doctor who specializes in skin conditions) usually diagnoses AKs. […] If an AK is left untreated, it could turn into a type of skin cancer called squamous cell carcinoma. How commonly does actinic keratosis turns into cancer? In about 5 percent to 10 percent of cases, an AK turns into skin cancer.

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