Actinic Keratosis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate actinic keratosis (AK):

Leading symptoms

• Foci of vulnerable skin, i.e., may bleed easily (diameter: 0.3-1 cm)
• Horn or wart-like growth

The clinical picture can be very diverse:

• Flat, erythematous (“accompanied by redness of the skin“), rough macules (color changes of the skin).
• Atrophic erythematous macules
• Erythematous rough papules (nodules) and plaques (areal or squamous substance proliferation of the skin)
• erythrosquamous (red/reddened (erythro) and on their surface scales (squamae)), flat papules (nodules).
• Flat, sunken papules
• hyperkeratotic (“strongly keratinizing”) papules, including the special form of cornu cutaneum (skin horn).

The diagnosis of actinic keratosis is usually based on the clinical picture as well as palpation findings. See classification “Clinical classification of actinic keratoses“.

One speaks of a field carcinization in the case of UV-related poikiloderma skin appearance (“colorful skin”) with telangiectasias (visible dilatations of superficially located smallest blood vessels), atrophy, hypo- and hyperpigmentation, and clinically visible or palpable (palpable) AKs.

Further notes

• Localization: the changes occur
  • Mainly occur in areas exposed to light (so-called sun terraces).
  • Usually occur on several parts of the body and can each reach a diameter of several centimeters.
• Often show
  • Signs of chronic photodamage in terms of wrinkling, elastosis (degeneration of the elastic fibers of the skin that occurs with age), actinic pigment disorders and telangiectasias (vascular veins).
  • Areal changes (by the layman) in the early stages not well recognized, but they are easily palpable as roughness (“like sandpaper”).

Warning signs (red flags) as possible indicators of transition from actinic keratoses to invasive squamous cell carcinoma