The lesions from actinic keratosis develop progressively from sun exposure and UV damage. Patients who are fair-skinned and frequently exposed to the sun are at higher risk for these lesions. Thus, they are encouraged to avoid the sun, use sunscreen and wear protective clothing.
These skin abnormalities occur in any sun-exposed area, and range between 2-6 mm in size. These can manifest as either papules (raised lesion less than 5 mm in size) or plaques (flat, raised lesion > 5 mm).
In the skin, these lesions cause thickening of the epidermis and a loss of the granular layer. This translates into small, rough lesions, which may show scaling.
Most often, the skin affected by actinic keratosis is erythematous (red), but can sometimes appear brownish.
These skin lesions are premalignant, and the risk of development into squamous cell carcinoma is directly proportional to the level of cell dysplasia. Biopsy can be done to make sure a very dysplastic lesion is not in fact a cancer.
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