Actinic keratosis

Actinic keratosis 1

Actinic keratosis is a benign neoplasm that primarily occurs on exposed areas of the skin in elderly individuals. It may be considered an early form of cutaneous squamous cell carcinoma. It is classified under the ICD-10 code L57.0.

Actinic keratosis typically occurs in individuals over the age of 50 and develops as a result of prolonged cumulative exposure to UV radiation on sun-exposed areas of the skin. The affected areas are predominantly located on the face and the back of the hands, and less commonly on the lower third of the forearms.

The following variants are distinguished based on histopathological examination:

  • Hyperkeratotic.
  • Atrophic.
  • Bowenoid.

The rash elements are sharply defined, dry, erythematous, slightly infiltrated small sized patches, covered with yellow-brown scales. Upon removal of the scales, pinpoint bleeding may occur. Pinpoint bleeding may occur when the scales are removed. Adjacent skin areas affected by prolonged sun exposure often show atrophy, telangiectasias, and dyspigmentation.

The diagnosis is established based on clinical manifestations and biopsy results. The histopathological features include focal disorganization of epitheliocytes with nuclear atypia in the Malpighian layer of the epidermis.

  • Squamous cell carcinoma
  • Chondrodermatitis
  • Basal cell carcinoma
  • Discoid lupus erythematosus

Treatment options include cryotherapy (double application of cryoprobe for 5 seconds), laser destruction. Cytostatic agents such as 1-2% fluorouracil cream may also be used. It is applied topically twice a day for 1 week, followed by a 1-week break and repeated for a total of 4-6 courses.

The use of photoprotective creams is necessary to prevent the development of actinic keratosis.

Prognosis: Actinic keratosis occasionally can transform into squamous cell carcinoma, less frequently into basal cell carcinoma.