Actinic (Solar) Keratosis

Synonyms

Solar keratoses; Senile keratosis

Definition

A premalignant cutaneous lesion (precursor form of cutaneous squamous cell carcinoma).

Basic Characteristics

Actinic keratosis typically occurs in fair-skinned individuals, especially in the elderly, and affects face, hands, bald scalp, and eyelids (areas with chronic ultraviolet exposure). Individuals who are immunosuppressed are also at higher risk.

Some authors consider these lesions to be precancerous and others consider them to be a squamous cell carcinoma confined to the lower portion of the epidermis (incipient intraepidermal squamous cell carcinoma) (Albert and Jakobiec 2008; Shields and Shields 2008).

Usually it presents as multiple, erythematous, scaly plaques on sun-exposed skin (Fig. 1). They may range from millimeters up to 1 cm in size. Frequently keratosis, or an elevated white flaky crust, is seen on the surface and a nodular, horny, or warty configuration can be present.

Fig. 1

Actinic ketatosis showing white scales...