What Does Cancerous Keratosis Look Like? Actinic Keratosis Guide
What does a cancerous keratosis look like?
The Quick Answer
**Actinic keratosis (AK)**—a precancerous lesion—appears as rough, scaly patches ranging from skin-colored to reddish-brown, sometimes with yellow-brown crust. Unlike infected scabs, AKs feel sandpapery, persist for months/years without healing, and occur on sun-exposed areas (face, ears). Untreated AKs progress to squamous cell carcinoma in 5–10% of cases.
Why We Ask This
Patients mistake persistent AKs for 'dry skin' or minor scabs, delaying dermatology referral until malignant transformation occurs—especially dangerous on facial sites where reconstruction complexity increases with tumor size.
The Practical Science
AKs result from UV-induced DNA damage in keratinocytes, showing histologic atypia. The 'yellow crust' variant (hypertrophic AK) features thick scale from hyperkeratosis—distinct from infectious crusting by its adherence, lack of inflammation, and chronicity (>3 months).
In Clinical Practice
A 65-year-old with a sandpapery, yellow-crusted patch on the temple persisting 6 months despite moisturizers requires biopsy. If confirmed AK, field treatment with 5-fluorouracil cream prevents progression while addressing subclinical lesions across sun-damaged areas.
References & Context
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