What is it?
An actinic keratosis (AK), also known as a solar keratosis, is a scaly or crusty bump that arises on the skin surface. The base may be light or dark, tan, pink, red, or a combination of these. . . or the same color as your skin. The scale or crust is horny, dry, and rough, and is often recognized by touch rather than sight. Occasionally it itches or produces a pricking or tender sensation. It can also become inflamed and surrounded by redness. In rare instances, actinic keratoses can even bleed.

The skin abnormality or lesion develops slowly and generally reaches a size from an eighth to a quarter of an inch. Early on, it may disappear only to reappear later. You will often see several AKs at a time.

An AK is most likely to appear on the face, ears, scalp, neck, backs of the hands and forearms, shoulders, and lips - the parts of the body most often exposed to sunshine. The growths may be flat and pink or raised and rough.

It should be noted that the topic of AK's is one receiving much attention form dermatologists. Some believe that they actually represent a superficial form of squamous cell skin caner. Indeed, if you look at a biopsy specimen under the microscope, the upper portion of an actinic keratosis cannot be differentiated from a squamous cell carcinoma. It is debated, but many think this lesion represents a superficial squamous cell skin cancer with a very low potential of additional growth. Traditionally, AK's, are at the very least, considered to be pre-cancerous lesions.

Why is it dangerous?
AK can be the first step in the development of skin cancer. It is thus a precursor of cancer or a precancer.

If treated early, almost all AKs can be eliminated without becoming skin cancers. But untreated, about two to five percent of these lesions may progress to squamous cell carcinomas. In fact, some scientists now believe that AK is the earliest form of SCC. These cancers are usually not life-threatening, provided they are detected and treated in the early stages. However, if this is not done, they can grow large and invade the surrounding tissues and, on rare occasions, metastasize or spread to the internal organs.

Another form of AK, actinic cheilitis, develops on the lips and may evolve into a type of SCC that can spread rapidly to other parts of the body.

If you have AKs, it indicates that you have sustained sun damage and could develop any kind of skin cancer - not just squamous cell carcinoma. The more keratoses that you have, the greater the chance that one or more may turn into skin cancer. People may also have up to 10 times as many subclinical (invisible) lesions as visible, surface lesions.

What does it look like?
Common forms of actinic keratoses are shown here in the locations where they most often develop. Examine your skin to find any lesions that look like these. if you spot them, consult your doctor promptly.
(above information, except photographs, from Skin Cancer Foundation)

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Dr. Crutchfield recommends the following helpful Patient information:
American Academy of Dermatology: Actinic keratosis
American Academy of Dermatology: Skin Cancer