Actinic Keratosis | AK

Actinic Keratosis, AK, is a common precancerous skin condition caused by prolonged exposure to UV radiation. These lesions can take various forms, each with distinct characteristics. Understanding these types helps in recognizing and effectively treating AK before it potentially progresses to squamous cell carcinoma.

1. Hypertrophic Actinic Keratosis

Hypertrophic AK is characterized by thicker, raised lesions that often feel rough or warty. These lesions can be more pronounced and may have a higher risk of developing into skin cancer. Because of their thicker nature, they often require more aggressive treatments such as cryotherapy.

2. Atrophic Actinic Keratosis

Atrophic AK presents as flat, scaly patches that are less thickened than hypertrophic types. These lesions may be pink or red and are often subtler, making them easier to overlook. Treatments such as topical medications or cryotherapy are commonly effective for atrophic AKs.

3. Lichenoid Actinic Keratosis

Lichenoid AK resembles lichen planus, presenting as inflamed, red, scaly patches. These lesions may be itchy and uncomfortable, requiring a combination of anti-inflammatory treatments and standard therapies for actinic keratosis.

4. Pigmented Actinic Keratosis

Pigmented AKs are darker than typical actinic keratoses, appearing as brown or black spots. Their appearance can sometimes mimic melanoma, necessitating careful evaluation to rule out more serious conditions. Treatment options include topical therapies and cryotherapy.

5. Bowenoid Actinic Keratosis

Bowenoid AK resembles early-stage squamous cell carcinoma (Bowen's disease) and is considered a form of early squamous cell carcinoma. These lesions appear as thick, scaly, red patches and are treated aggressively to prevent progression.

Treatment and Prevention

Treatment of actinic keratosis varies depending on the type and severity of the lesion. Options include:

• Cryotherapy for most AKs, particularly hypertrophic and atrophic types.

• Topical treatments such as 5-fluorouracil (5-FU) or imiquimod for widespread or superficial lesions.

• Photodynamic Therapy (PDT) for large or multiple lesions.

• Curettage and electrodessication for more severe or suspicious lesions.

Preventing AKs involves diligent sun protection, including daily use of sunscreen, wearing protective clothing, and avoiding peak sun exposure. Regular skin checks, both self-examinations and professional evaluations, are crucial for early detection and treatment.

At Naples Dermatology, our team is skilled in diagnosing and treating all forms of actinic keratosis. We provide personalized care plans to manage and reduce the risk of skin cancer progression, ensuring the best outcomes for our patients.

For more information or to schedule a consultation, visit our Contact Us page.