Actinic keratoses have the following characteristics:
- Lesions typically occur on the surface of the skin and have a sandpaper-like feel. In fact, they are sometimes more easily felt than seen.
- Most lesions are pink and even flesh-colored. Some are red or brown, scaly, and tender. At times, they can resemble melanomas; even dermatologists may have trouble telling the two apart.
- They can range in size from microscopic to several inches in diameter.
Keratoacanthomas. Keratoacanthomas closely resemble squamous cell carcinomas, but they are not malignant. The majority occur in sun-exposed skin, usually on the hands or face. They are typically skin colored or slightly reddish when they first develop, but their appearance typically changes:
- In the early stages, keratoacanthomas are smooth, red, and dome shaped.
- Within a few weeks, they can grow rapidly, usually to 1 or 2 centimeters. Some reach the size of a quarter in less than a month and can be rather disfiguring.
- They eventually stop growing and become crater-like with an outer rim of tissue surrounding and a sometimes crusty interior.
Most will spontaneously regress within a year, but they almost always scar after healing. Also about 25% develop into squamous cell carcinomas, most frequently in older people and in sun-exposed areas. Removal by surgery (sometimes by radiation) is recommended. They may also be treated with 5-fluorouracil, either as a cream (Efudex) or with injections.
Previous Section
