Topic
Review Topic
0
0
https://upload.orthobullets.com/topic/12760/images/at.jpg
Introduction
  • Keratotic, pre-malignant lesions
  • Epidemiology
    • common in fair-skinned individuals
    • common in elderly patients
    • results from significant lifetime sun exposure
      • keratinocyte damage
  • Associated conditions
    • may lead to squamous cell carcinoma 
  • Prognosis
    • typically slow-growing and persistent if untreated
  • Prognosis
Presentation
  • Symptoms
    • typically asymptomatic
    • occasionally tender
  • Physical exam
    • thin, adherent transparent or yellow scale that progressively increases in thickness
    • often with telangiectasias
    • can progress to cutaneous horn 
      • difficult to distinguish from squamous cell carcinoma at this point
    • rough, “sand-paper” texture
      • often easier to detect by palpation rather than observation
    • frequently on sun-exposed areas
      • face, head, neck, dorsal hands, ears
Evaluation
  • Skin biopsy
    • dysplastic epidermis with keratinocyte atypia
      • hyperkeratotic cell with lower epithelial cells showing loss of polarity and hyperchromatic nuclei
      • no invasion into dermis
Differential
  • Squamous cell carcinoma
  • Actinic cheilitis
  • Lentigo maligna
Treatment
  • Prevention
    • Annual follow-up for skin cancer monitoring
    • avoid sun exposure
    • use sunscreen
  • Lifestyle modification
    • avoid sun exposure
    • use sunscreen
  • Surgical
    • liquid nitrogen (cryotherapy) = most common treatment
    • electrodesiccation and curettage
  • Pharmacological
    • topical 5-fluorouracil
      • typically reserved for those with widespread actinic keratoses
Complications
  • Prognosis
    • typically slow-growing and persistent if untreated
  • Prevention
    • avoid sun exposure
    • use sunscreen
  • Complications
    • risk of progression to squamous cell carcinoma
 

Please rate topic.

Average 5.0 of 1 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (0)
Private Note