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What Do AKs Look Like?
AKs are found on chronically
sun-exposed areas anywhere on the body, most commonly on a fair-skinned
person middle-aged or older. The typical AK lesion is a dry, scaly,
skin-colored, reddish-brown or yellowish-black macule
(circumscribed flat lesion of any size or shape) or papule
(small, solid elevated lesion—a "bump" on the skin). AK
lesions may range from papules the size of a pinhead to scaly papules
and macules several centimeters in diameter. The most dramatic AK lesion
is the cutaneous horn, described later. Skin-colored AK lesions
may be more apparent to the touch—as scaly, dry, bumpy skin—than to
visual perception. Wrinkling and furrowing, other manifestations of
solar damage, may be present simultaneously with AK lesions.
These photos show typical presentations
of Actinic Keratoses:
A fair-skinned older
person has numerous crusted papules on the backs of both hands, and on
other chronically sun-exposed parts of the body.
A typical presentation
of AK.
(Photos used in
discussion of actinic keratoses are with permission of the American
Academy of Dermatology National Library of Dermatologic Teaching Slides
and the Sulzberger Institute for Dermatologic Education)
Sometimes the skin cells making up an
AK lesion undergo unusually abnormal growth into a cutaneous horn.
The cutaneous horn gets its name from its appearance—it can resemble
the horn of an animal. The horn may be relatively small to several
centimeters in size; its shape may be straight, curved or twisted. The
ear is a common site for a cutaneous horn, probably because the ear is a
chronically sun-exposed site.
The photo shows a typical presentation
of cutaneous horn:
Cutaneous horn.
An AK can also appear as a diffuse,
scaling lesion of the lower lip (actinic cheilitis); as a variably
pigmented, scaly lesion on the face; and, bright red, violet, or brown
multiple papules resembling the skin condition called lichen planus.
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