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Difference between revisions of "Actinic keratosis"
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→Histologic subtypes of actinic keratosis
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| Prognosis = good | | Prognosis = good | ||
| Other = | | Other = | ||
| ClinDDx = [[squamous cell carcinoma of the skin|squamous cell carcinoma]] | | ClinDDx = [[squamous cell carcinoma of the skin|squamous cell carcinoma]], [[melanoma]] (for pigmented AK) | ||
}} | }} | ||
'''Actinic keratosis''', abbreviated '''AK''', is a common [[skin]] lesion. It is also known as '''solar keratosis'''.<ref name=pmid18393780>{{Cite journal | last1 = Weinberg | first1 = JM. | title = Topical therapy for actinic keratoses: current and evolving therapies. | journal = Rev Recent Clin Trials | volume = 1 | issue = 1 | pages = 53-60 | month = Jan | year = 2006 | doi = | PMID = 18393780 }}</ref><ref name=pmid18067626>{{Cite journal | last1 = Roewert-Huber | first1 = J. | last2 = Stockfleth | first2 = E. | last3 = Kerl | first3 = H. | title = Pathology and pathobiology of actinic (solar) keratosis - an update. | journal = Br J Dermatol | volume = 157 Suppl 2 | issue = | pages = 18-20 | month = Dec | year = 2007 | doi = 10.1111/j.1365-2133.2007.08267.x | PMID = 18067626 }}</ref> | '''Actinic keratosis''', abbreviated '''AK''', is a common [[skin]] lesion. It is also known as '''solar keratosis'''.<ref name=pmid18393780>{{Cite journal | last1 = Weinberg | first1 = JM. | title = Topical therapy for actinic keratoses: current and evolving therapies. | journal = Rev Recent Clin Trials | volume = 1 | issue = 1 | pages = 53-60 | month = Jan | year = 2006 | doi = | PMID = 18393780 }}</ref><ref name=pmid18067626>{{Cite journal | last1 = Roewert-Huber | first1 = J. | last2 = Stockfleth | first2 = E. | last3 = Kerl | first3 = H. | title = Pathology and pathobiology of actinic (solar) keratosis - an update. | journal = Br J Dermatol | volume = 157 Suppl 2 | issue = | pages = 18-20 | month = Dec | year = 2007 | doi = 10.1111/j.1365-2133.2007.08267.x | PMID = 18067626 }}</ref> | ||
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*Yellow-brown scaly, patches. | *Yellow-brown scaly, patches. | ||
*Sandpaper sensation - on touching. | *Sandpaper sensation - on touching. | ||
*Usually small (<1cm), but larger lesions may occur. | |||
*May be pigmented.<ref>URL: [http://www.dermoscopy-ids.org/index.php/newest-case/79-lentigo-maligna-vs-pigmented-actinic-keratosis http://www.dermoscopy-ids.org/index.php/newest-case/79-lentigo-maligna-vs-pigmented-actinic-keratosis]. Accessed on: 23 August 2012.</ref> | *May be pigmented.<ref>URL: [http://www.dermoscopy-ids.org/index.php/newest-case/79-lentigo-maligna-vs-pigmented-actinic-keratosis http://www.dermoscopy-ids.org/index.php/newest-case/79-lentigo-maligna-vs-pigmented-actinic-keratosis]. Accessed on: 23 August 2012.</ref> | ||
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*[[Squamous cell carcinoma of the skin]]. | *[[Squamous cell carcinoma of the skin]]. | ||
*[[Lentigo maligna]] (melanoma in situ on sun damaged skin) - esp. for ''pigmented AK''.<ref name=Ref_Derm353>{{Ref Derm|353}}</ref> | *[[Lentigo maligna]] (melanoma in situ on sun damaged skin) - esp. for ''pigmented AK''.<ref name=Ref_Derm353>{{Ref Derm|353}}</ref> | ||
**One should see benign melanocytes within an AK... otherwise one should do stains as the melanocytes may be mimicking keratinocytes. | |||
*[[Seborrheic keratosis]] - should not have basilar nuclear atypia. | *[[Seborrheic keratosis]] - should not have basilar nuclear atypia. | ||
*[[Lichenoid keratosis]] (esp. for ''lichenoid actinic keratosis'') - has a band of inflammatory cells in the superficial dermis. | |||
*Discoid Luphus Erythematosus. | |||
===Images=== | ===Images=== | ||
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Image:SkinTumors-P5280065.JPG | Actinic keratosis. (WC) | Image:SkinTumors-P5280065.JPG | Actinic keratosis. (WC) | ||
Image:SkinTumors-P5280055.JPG | Actinic keartosis. (WC) | Image:SkinTumors-P5280055.JPG | Actinic keartosis. (WC) | ||
Image:SkinTumors-P5280056.JPG | Actinic keratosis. (WC) | |||
</gallery> | |||
<gallery> | |||
Image:Bowenoid_actinic_keratosis_-_high_mag.jpg | Bowenoid actinic keratosis - high mag. (WC) | Image:Bowenoid_actinic_keratosis_-_high_mag.jpg | Bowenoid actinic keratosis - high mag. (WC) | ||
Image:Bowenoid_actinic_keratosis_-_very_high_mag.jpg | Bowenoid actinic keratosis - very high mag. (WC) | Image:Bowenoid_actinic_keratosis_-_very_high_mag.jpg | Bowenoid actinic keratosis - very high mag. (WC) | ||
</gallery> | </gallery> | ||
===Histologic subtypes of actinic keratosis=== | ===Histologic subtypes of actinic keratosis=== | ||
Like most common things, there are several variants:<ref name=Ref_Derm353>{{Ref Derm|353}}</ref> | Like most common things, there are several variants:<ref name=Ref_Derm353>{{Ref Derm|353}}</ref> | ||
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*Pigmented actinic keratosis. | *Pigmented actinic keratosis. | ||
**DDx: [[lentigo maligna]]. | **DDx: [[lentigo maligna]]. | ||
*Lichenoid actinic keratosis. | *Lichenoid actinic keratosis - band of inflammatory cells at the dermal-epidermal junction. | ||
**DDx: [[lichen planus]]. | |||
*Atrophic actinic keratosis. | |||
==Sign out== | ==Sign out== | ||
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There is no clefting of the lesion from the surrounding stroma. Intercellular bridges are identified. | There is no clefting of the lesion from the surrounding stroma. Intercellular bridges are identified. | ||
=====Lichenoid AK===== | |||
The sections show skin with a lymphoplasmacytic interface dermatitis, hypergranulosis, hyperkeratosis, loss of the rete ridges and apoptotic keratinocytes. The epidermis matures to the surface; however, there is basal cell hyperplasia associated with moderate keratinocyte nuclear atypia (including hyperchromasia and anisonucleosis). Pigment incontinence is present. Solar elastosis is present. The lesion is completely excised in the plane of section. | |||
==See also== | ==See also== | ||