Pre-Malignant Dermatology

Actinic Keratosis (AK): UV-Induced Dysplasia, Progression to SCC & Field Therapy

Author: Mallikarjun R (Founder) & Medicus Labs Medical Team • Review: 10 min read • ✓ Peer-Referenced

1. The Pre-Cancerous Continuum

Actinic Keratoses (AKs) are intraepidermal keratinocyte neoplasms that manifest as erythematous, gritty, "sandpaper-textured" papules on sun-damaged skin. Approximately 10% of untreated AKs progress into invasive squamous cell carcinoma over a 10-year horizon.

2. Treatment: Lesion-Directed vs. Field-Directed

Lesion-directed liquid nitrogen cryotherapy destroys discrete keratoses. Field-directed therapy (topical 5-Fluorouracil 5%, Imiquimod 3.75–5%, or Photodynamic Therapy [PDT]) treats subclinical dysplastic cells across the entire sun-damaged anatomical zone.