Case history
Case history
A 65-year-old man with light-coloured skin presents with asymptomatic pink and yellowish scaly, irregularly shaped, rough papules and macules. The lesions are localised on the scalp, forehead, ears, dorsal forearms, and dorsal aspect of hands, over chronically sun damaged-looking skin. He has been working outdoors for many years without wearing any sun cream or protective clothing. He has had previous treatment with curettage, cryotherapy, and topical fluorouracil. He is presenting with new lesions, and is concerned about developing skin cancer.
Other presentations
Other clinical presentations include: scaly lesions with a hyperkeratotic surface (hyperkeratotic AKs); well-defined, scaly, brown lesions resembling solar lentigo (pigmented AKs); lesions resembling seborrhoeic keratosis, melanocytic naevus, and early malignant melanoma (spreading pigmented AKs); skin-coloured, papillomatous, elevated wart-like papules (verrucous AKs); plaques with very mild scale over very thin shiny skin (atrophic AKs); violaceous well-defined papules with fine white lines on the surface (lichen planus-like or lichenoid AKs); hypertrophic conical-shaped protuberances growing from the surface of the skin (cutaneous horn); and scaly red roughness with induration, fissuring, and ulceration of the lower lip to the commissures (actinic cheilitis).[1][4][5]
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