An actinic keratosis is a rough, scaly patch on your skin that develops from years of exposure to the sun. It's most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck. Also known as solar keratosis, an actinic keratosis enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin.
Over time, actinic keratoses may develop into invasive squamous cell carcinoma; according to one study of almost 7000 patients, among the small percentage of actinic keratoses that progress into squamous cell carcinoma, the length of time for this transformation to occur was approximately 2 years.Cells within actinic keratoses (AKs) show characteristic UV-induced gene mutations.Histologically AKs share features with squamous cell carcinoma (SCC).
Actinic keratosis affects predominantly the sun-exposed areas of fair-skinned people. The incidence in elderly whites may approach 100% in some populations. The appearance of actinic keratosis may be at a much younger age (under 30 years) if the susceptible individuals have an outdoor occupation, such as farmers, ranchers, and sailors, or have an outdoor lifestyle in sports or recreation.
The flat actinic keratosis lesions are most easily treated with cryotherapy. Application of liquid nitrogen with either a Q-tip or a spray gun for 10 to 15 s will suffice in the majority of cases. Retreatment may be necessary for the more stubborn lesions. It is not necessary to freeze to the point of blistering. Curettage and electrodesiccation of the lesions is equally effective, but carries a slightly greater risk of scarring and dyspigmentation.