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Features:<ref>URL: [http://emedicine.medscape.com/article/1099775-workup#a0723 http://emedicine.medscape.com/article/1099775-workup#a0723]. Accessed on: 1 September 2011.</ref> | Features:<ref>URL: [http://emedicine.medscape.com/article/1099775-workup#a0723 http://emedicine.medscape.com/article/1099775-workup#a0723]. Accessed on: 1 September 2011.</ref> | ||
*Epidermal nuclear atypia: | *Epidermal nuclear atypia: | ||
**Variation is size, shape and staining. | **Variation is size, shape and staining - must involve basilar layer. | ||
***Nuclear enlargement - '''key feature'''. | ***Nuclear enlargement - '''key feature'''. | ||
*** | ***Hyperchromasia. | ||
*Abnormal epidermal architecture: | *Abnormal epidermal architecture: | ||
**Palisading.{{Fact}} | **Palisading.{{Fact}} | ||
*+/-Parakeratosis. | *+/-Parakeratosis - may alternate with orthokeratosis, esp. early lesions.<ref name=Ref_Derm353>{{Ref Derm|353}}</ref> | ||
*+/-Irregular acanthosis. | *+/-Irregular acanthosis. | ||
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*[[Squamous cell carcinoma]]. | *[[Squamous cell carcinoma]]. | ||
*[[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> | ||
*[[Seborrheic keratosis]] - should not have basilar nuclear atypia. | |||
Images: | Images: | ||
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*[http://commons.wikimedia.org/wiki/File:Bowenoid_actinic_keratosis_-_high_mag.jpg Bowenoid actinic keratosis - high mag. (WC)]. | *[http://commons.wikimedia.org/wiki/File:Bowenoid_actinic_keratosis_-_high_mag.jpg Bowenoid actinic keratosis - high mag. (WC)]. | ||
*[http://commons.wikimedia.org/wiki/File:Bowenoid_actinic_keratosis_-_very_high_mag.jpg Bowenoid actinic keratosis - very high mag. (WC)]. | *[http://commons.wikimedia.org/wiki/File:Bowenoid_actinic_keratosis_-_very_high_mag.jpg Bowenoid actinic keratosis - very high mag. (WC)]. | ||
====Histologic subtypes==== | |||
Like most common things, there are several variants:<ref name=Ref_Derm353>{{Ref Derm|353}}</ref> | |||
*Hypertrophic actinic keratosis. | |||
*Acantholytic actinic keratosis. | |||
*Proliferative actinic keratosis - downward finger-like projections of the epidermis. | |||
*Pigmented actinic keratosis - DDx [[lentigo maligna]]. | |||
*Lichenoid actinic keratosis. | |||
==Seborrheic keratosis== | ==Seborrheic keratosis== |
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