From the Guidelines
Actinic keratosis papules are typically described as rough, scaly papules on an erythematous base that develop in anatomic areas of high ultraviolet (UV) exposure. These lesions can have distinct presentations, including variants that range in appearance from atrophic to profoundly hypertrophic (or hyperkeratotic), and can also be pigmented or bowenoid in appearance 1. The amount of adherent scale can alter the appearance of AKs, with thicker amounts of epidermal hyperkeratosis usually associated with increased visibility and roughness.
- Key characteristics of actinic keratosis papules include:
- Rough, scaly texture
- Erythematous base
- Development in areas of high UV exposure
- Variants in appearance, including atrophic, hypertrophic, pigmented, and bowenoid types
- Presence of cutaneous horns in some cases According to the guidelines of care for the management of actinic keratosis, published in the Journal of the American Academy of Dermatology in 2021 1, these lesions can have a range of clinical presentations, and classification systems that assess both clinical and histologic characteristics or dermatoscopic findings are available.
From the FDA Drug Label
1.1 Actinic Keratosis Imiquimod Cream is indicated for the topical treatment of clinically typical, nonhyperkeratotic, nonhypertrophic actinic keratoses on the face or scalp in immunocompetent adults. The studies enrolled subjects with 4 to 8 clinically typical, visible, discrete, nonhyperkeratotic, nonhypertrophic AK lesions within a 25 cm2 contiguous treatment area on either the face or scalp.
The actinic keratosis papule is described as clinically typical, visible, discrete, nonhyperkeratotic, nonhypertrophic lesions on the face or scalp in immunocompetent adults 2 2.
- Key characteristics:
- Clinically typical
- Visible
- Discrete
- Nonhyperkeratotic
- Nonhypertrophic Located on the face or scalp.
From the Research
Description of Actinic Keratosis Papule
Actinic keratosis (AK) is described as a skin disease caused by chronic sun damage, which in 75% of cases arises on chronically sun-exposed areas, such as the face, scalp, neck, hands, and forearms 3. It is characterized by intraepithelial keratinocyte dysplasia and molecular alterations shared with normal chronically sun-damaged skin and squamous cell carcinoma (SCC) 4.
Characteristics of Actinic Keratosis
The key characteristics of actinic keratosis include:
- Premalignant skin lesions with the risk of converting into squamous cell carcinoma 5
- Potential to undergo spontaneous regression, stable existence, or malignant transformation to cutaneous SCC 4
- Progression rates to SCC ranging from 0% to 0.5% per lesion-year and AK spontaneous regression of 15-63% 4
Clinical Presentation
Actinic keratosis papules are often associated with alteration of the surrounding skin (field) where subclinical lesions might be present 6. The clinical presentation of AK can vary, but it is commonly described as a skin lesion that can be felt and seen on sun-exposed areas.
Treatment Options
There are various treatment options available for actinic keratosis, including: