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Actinic Keratosis
Etiology

Actinic keratosis is, as the name implies, associated with sun exposure.
Long term exposure to the sun is the causative factor.
Pathogenesis

Believed to represent a response of the skin to UV rays.,
Epidemiology

It is seen primarily in the area of the face, upper back in light-skinned men and the legs of light-skinned women.
General Gross Description

The lesion may appear as a roughened area of skin with some evidence of hyperemia and a tendency to ulceration.
•Examples:
General Microscopic Description

Histologically, the actinic keratosis lesion may be visualized as a carcinoma in situ of the skin.
Thus, instead of the normal orderly progression of basal layer, stratum spinosum, granular cell layer, stratum corneum, there is a loss of polarity of cells.
Mitoses are seen at layers above the basal layer.
There is a failure of orderly maturation of the nucleus from vesicular to condensed to fragmentaton and loss of nuclear materials
There is a tendency to abrupt and unscheduled keratinization
There is a tendency to hyperchromatic and aberrant nuclear morphology.
In addition, some evidence of infiltration of the upper dermis with inflammatory cells is often noticed.
Actinic keratosis is almost always accompanied by a bluish discoloration of the papillary dermis indicative of UV damage to the connective tissue of the papillary dermis.
•Examples:
Solar elastosis Solar elastosis
Clinical Correlation

May progress to frank malignancy.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1185.

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Actinic Keratosis
Synopsis by: T.V.Rajan, M.D., Ph.D. (T01000M72850)[513]
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