Actinic keratosis - Knowledge (XXG)

1009:, thereby interrupting DNA and RNA synthesis. This in turn prevents the proliferation of dysplastic cells in AK. Topical 5-FU is the most utilized treatment for AK, and often results in effective removal of the lesion. Overall, there is a 50% efficacy rate resulting in 100% clearance of AKs treated with topical 5-FU. 5-FU may be up to 90% effective in treating non-hyperkeratotic lesions. While topical 5-FU is a widely used and cost-effective treatment for AKs and is generally well tolerated, its potential side-effects can include: pain, crusting, redness, and local swelling. These adverse effects can be mitigated or minimized by reducing the frequency of application or taking breaks between uses. The most commonly used application regimen consists of applying a layer of topical cream to the lesion twice a day after washing; duration of treatment is typically 2–4 weeks to thinner skin like the cheeks and up to 8 weeks for the arms; treatment of up to 8 weeks has demonstrated a higher cure rate. 422:(HPV) plays a role in the development of AKs. The HPV virus has been detected in AKs, with measurable HPV viral loads (one HPV-DNA copy per less than 50 cells) measured in 40% of AKs. Similar to UV radiation, higher levels of HPV found in AKs reflect enhanced viral DNA replication. This is suspected to be related to the abnormal keratinocyte proliferation and differentiation in AKs, which facilitate an environment for HPV replication. This in turn may further stimulate the abnormal proliferation that contributes to the development of AKs and carcinogenesis. 1044:

gel is recommended for the scalp and face, while a 2-day treatment course with the 0.05% gel is recommended for the trunk and extremities. Treatment with the 0.015% gel was found to completely clear 57% of AK, while the 0.05% gel had a 34% clearance rate. Advantages of ingenol mebutate treatment include the short duration of therapy and a low recurrence rate. Local skin reactions including pain, itching and redness can be expected during treatment with ingenol mebutate. This treatment was derived from the petty spurge,

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including local erythema, scabbing, and flaking at the application site, while nearly a third of individuals using the 5% cream reported the same types of reactions with Imiquimod treatment. However, it is ultimately difficult to compare the efficacy of the different strength creams directly, as current study data varies in methodology (e.g. duration and frequency of treatment, and amount of skin surface area covered).

572: 698: 1303: 1144: 58: 879: 1241:) lasers is a treatment approach being utilized with increased frequency, and sometimes in conjunction with computer scanning technology. Laser therapy has not been extensively studied, but current evidence suggests it may be effective in cases involving multiple AKs refractive to medical therapy, or AKs located in cosmetically sensitive locations such as the face. The CO 1028:. Treatment with Imiquimod cream applied 2–3 times per week for 12 to 16 weeks was found to result in complete resolution of AKs in 50% of people, compared to 5% of controls. The Imiquimod 3.75% cream has been validated in a treatment regimen consisting of daily application to entire face and scalp for two 2-week treatment cycles, with a complete clearance rate of 36%. 971: 1335:

particularly after unprotected sun exposure. Left untreated, there is a chance that the lesion will advance to become invasive. Although it is difficult to predict whether an AK will advance to become squamous cell carcinoma, it has been noted that squamous cell carcinomas originate in lesions formerly diagnosed as AKs with frequencies reported between 65 and 97%.

536:: People with a compromised immune system from medical conditions (such as AIDS) or immunosuppressive therapy (such as chronic immunosuppression after organ transplantation, or chemotherapy for cancer) are at increased risk for developing AKs. They may develop AK at an earlier age or have an increased number of AK lesions compared to immunocompetent people. 7239: 1117: 980:

There are a variety of treatment options for AK depending on the patient and the clinical characteristics of the lesion. AKs show a wide range of features, which guide decision-making in choosing treatment. As there are multiple effective treatments, patient preference and lifestyle are also factors

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Recent research implicating human papillomavirus (HPV) in the development of AKs suggests that HPV prevention might in turn help prevent development of AKs, as UV-induced mutations and oncogenic transformation are likely facilitated in cases of active HPV infection. A key component of HPV prevention

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is frequently used for few and well-defined lesions, but undesired skin lightening, or hypopigmentation, may occur at the treatment site. By following up with a dermatologist, AKs can be treated before they progress to skin cancer. If cancer does develop from an AK lesion, it can be caught early with

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Given the aforementioned differering clinical outcomes, it is difficult to predict the clinical course of any given actinic keratosis. AK lesions may also come and go—in a cycle of appearing on the skin, remaining for months, and then disappearing. Often they will reappear in a few weeks or months,

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is a topically applied agent that wounds the outermost layer of the skin, promoting organized repair, exfoliation, and eventually the development of smooth and rejuvenated skin. Multiple therapies have been studied. A medium-depth peel may effectively treat multiple non-hyperkeratotic AKs. It can be

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when deemed appropriate by the physician): This technique is often used for treatment of AKs, and particularly for lesions appearing more similar to squamous cell carcinoma, or those that are unresponsive to other treatments. The surface of the lesion can be scraped away using a scalpel, or the base

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Multiple treatment regimens using different photosensitizers, incubation times, light sources, and pretreatment regimens have been studied and suggest that longer incubation times lead to higher rates of lesion clearance. Photodynamic therapy is gaining in popularity. It has been found to have a 14%

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Treatment begins with preparation of the lesion, which includes scraping away scales and crusts using a dermal curette. A thick layer of topical MAL or 5-ALA cream is applied to the lesion and a small area surrounding the lesion, which is then covered with an occlusive dressing and left for a period

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is a newer treatment for AK used in Europe and the United States. It works in two ways, first by disrupting cell membranes and mitochondria resulting cell death, and then by inducing antibody-dependent cellular cytotoxicity to eliminate remaining tumor cells. A 3-day treatment course with the 0.015%

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is performed if the diagnosis remains uncertain after a clinical physical exam, or if there is suspicion that the AK might have progressed to squamous cell carcinoma. The most common tissue sampling techniques include shave or punch biopsy. When only a portion of the lesion can be removed due to its

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Balding: AKs are commonly found on the scalps of balding men. The degree of baldness seems to be a risk factor for lesion development, as men with severe baldness were found to be seven times more likely to have 10 or more AKs when compared to men with minimal or no baldness. This observation can be

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Progression: The overall risk of an AK turning into invasive cancer is low. In average-risk individuals, likelihood of an AK lesion progressing to SCC is less than 1% per year. Despite this low rate of progression, studies suggest that a full 60% of SCCs arise from pre-existing AKs, reinforcing the

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Cryotherapy is particularly indicated for cases where there are fewer than 15 thin, well-demarcated lesions. Caution is encouraged for thicker, more hyperkeratotic lesions, as dysplastic cells may evade treatment. Treatment with both cryotherapy and field treatment can be considered for these more

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gel is a nonsteroidal anti-inflammatory drug that is thought to work in the treatment of AK through its inhibition of the arachidonic acid pathway, thereby limiting the production of prostaglandins which are thought to be involved in the development of UVB-induced skin cancers. Recommended duration

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Bowenoid: This term is controversial and usually refers to full-thickness atypia, microscopically indistinguishable from Bowen's Disease. However most dermatologists and pathologists will use it in reference to tissue samples that are notable for small foci of atypia that involve the full thickness

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The lesions are usually asymptomatic, but can be tender, itch, bleed, or produce a stinging or burning sensation. AKs are typically graded in accordance with their clinical presentation: Grade I (easily visible, slightly palpable), Grade II (easily visible, palpable), and Grade III (frankly visible

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Given the causal relationship between sun exposure and AK growth, they often appear on a background of sun-damaged skin and in areas that are commonly sun-exposed, such as the face, ears, neck, scalp, chest, backs of hands, forearms, or lips. Because sun exposure is rarely limited to a small area,

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Men are more likely to develop AK than women, and the risk of developing AK lesions increases with age. These findings have been observed in multiple studies, with numbers from one study suggesting that approximately 5% of women ages 20–29 develop AK compared to 68% of women ages 60–69, and 10% of

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of variable thickness with surrounding redness; they have a sandpaper-like texture when felt with a gloved hand. Skin nearby the lesion often shows evidence of solar damage characterized by pigmentary alterations, being yellow or pale in color with areas of hyperpigmentation; deep wrinkles, coarse

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When compared to treatment with 5-FU, chemical peels have demonstrated similar efficacy and increased ease of use with similar morbidity. Chemical peels must be performed in a controlled clinic environment and are recommended only for individuals who are able to comply with follow-up precautions,

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Carneiro RV, Sotto MN, Azevedo LS, Ianhez LE, Rivitti EA (February 2005). "Acitretin and skin cancer in kidney transplanted patients. Clinical and histological evaluation and immunohistochemical analysis of lymphocytes, natural killer cells and Langerhans' cells in sun exposed and sun protected

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Geography seems to play a role in the sense that individuals living in locations where they are exposed to more UV radiation throughout their lifetime have a significantly higher risk of developing AK. Much of the literature on AK comes from Australia, where the prevalence of AK is estimated at

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can be recognized as "IDRBEU": I (induration/inflammation), D (diameter > 1 cm), R (rapid enlargement), B (bleeding), E (erythema), and U (ulceration). AKs are usually diagnosed clinically, but because they are difficult to clinically differentiate from squamous cell carcinoma, any

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Werner RN, Stockfleth E, Connolly SM, Correia O, Erdmann R, Foley P, Gupta AK, Jacobs A, Kerl H, Lim HW, Martin G, Paquet M, Pariser DM, Rosumeck S, Röwert-Huber HJ, Sahota A, Sangueza OP, Shumack S, Sporbeck B, Swanson NA, Torezan L, Nast A (November 2015). "Evidence- and consensus-based (S3)

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While the clearance rate observed with the Imiquimod 3.75% cream was lower than that observed with the 5% cream (36 and 50 percent, respectively), there are lower reported rates of adverse reactions with the 3.75% cream: 19% of individuals using Imiquimod 3.75% cream reported adverse reactions

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Extent of sun exposure: Cumulative sun exposure leads to an increased risk for development of AKs. In one U.S. study, AKs were found in 55% of fair-skinned men with high cumulative sun exposure, and in only 19% of fair-skinned men with low cumulative sun exposure in an age-matched cohort (the

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Kaufmann R, Spelman L, Weightman W, Reifenberger J, Szeimies RM, Verhaeghe E, Kerrouche N, Sorba V, Villemagne H, Rhodes LE (May 2008). "Multicentre intraindividual randomized trial of topical methyl aminolaevulinate-photodynamic therapy vs. cryotherapy for multiple actinic keratoses on the

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The process can be repeated multiple times in one office visit, as tolerated. Cure rates from 67 to 99 percent have been reported, depending on freeze time and lesion characteristics. Disadvantages include discomfort during and after the procedure; blistering, scarring and redness; hypo- or

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Polarized contact dermoscopy of AKs occasionally reveals a "rosette sign," described as four white points arranged in a clover pattern, often localized to within a follicular opening. It is hypothesized that the "rosette sign" corresponds histologically to the changes of orthokeratosis and

314:: A cutaneous horn is a keratinic projection with its height at least one-half of its diameter, often conical in shape. They can be seen in the setting of actinic keratosis as a progression of an HAK, but are also present in other skin conditions. 38–40% of cutaneous horns represent AKs. 1175:

higher likelihood of achieving complete lesion clearance at 3 months compared to cryotherapy, and seems to result in superior cosmetic outcomes when compared to cryotherapy or 5-FU treatment. Photodynamic therapy can be particularly effective in treating areas with multiple AK lesions.

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is a noninvasive technique utilizing a handheld magnifying device coupled with a transilluminating lift. It is often used in the evaluation of cutaneous lesions but lacks the definitive diagnostic ability of biopsy-based tissue diagnosis. Histopathologic exam remains the gold standard.

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Ultraviolet radiation is believed to contribute to the development of actinic keratoses by inducing mutations in epidermal keratinocytes, leading to proliferation of atypical cells. Therefore, preventive measures for AKs are targeted at limiting exposure to solar radiation, including:

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Hauschild A, Popp G, Stockfleth E, Meyer KG, Imberger D, Mohr P, Itschert G, Kaufmann R, Neuber K, Frambach Y, Gollnick H, Brunnert M, Stocker M, Ortland C, Karrer S (February 2009). "Effective photodynamic therapy of actinic keratoses on the head and face with a novel, self-adhesive

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that physicians consider when determining the management plan for actinic keratosis. Regular follow-up is advisable after any treatment to make sure no new lesions have developed and that old ones are not progressing. Adding topical treatment after a procedure may improve outcomes.

476:: Studies show that even a single episode of painful sunburn as a child can increase an individual's risk of developing AK as an adult. Six or more painful sunburns over the course of a lifetime was found to be significantly associated with the likelihood of developing AK. 1343:

Actinic keratosis is very common, with an estimated 14% of dermatology visits related to AKs. It is seen more often in fair-skinned individuals, and rates vary with geographical location and age. Other factors such as exposure to ultraviolet (UV) radiation, certain

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Specific findings depend on the clinical variant and particular lesion characteristics. The seven major histopathologic variants are all characterized by atypical keratinocytic proliferation beginning in the basal layer and confined to the epidermis; they include:

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Atrophic: With slight hyperkeratosis and overall atrophic changes to the epidermis; the basal layer shows cells with large, hyperchromatic nuclei in close proximity to each other. These cells have been observed to proliferate into the dermis as buds and duct-like

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Swanson N, Abramovits W, Berman B, Kulp J, Rigel DS, Levy S (April 2010). "Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: results of two placebo-controlled studies of daily application to the face and balding scalp for two 2-week cycles".

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Szeimies RM, Torezan L, Niwa A, Valente N, Unger P, Kohl E, Schreml S, Babilas P, Karrer S, Festa-Neto C (July 2012). "Clinical, histopathological and immunohistochemical assessment of human skin field cancerization before and after photodynamic therapy".

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gel daily for 4 weeks, and then twice daily thereafter for a total of nine months led to a significant but modest reduction in the number AKs compared to placebo; it demonstrated the additional advantage of improving the appearance of photodamaged skin.

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40–50% in adults over 40, as compared to the United States and Europe, where prevalence is estimated at under 11–38% in adults. One study found that those who immigrated to Australia after age 20 had fewer AKs than native Australians in all age groups.

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is a pigment in the epidermis that functions to protect keratinocytes from the damage caused by UV radiation; it is found in higher concentrations in the epidermis of darker-skinned individuals, affording them protection against the development of AKs.

190:(PDT) is one option for the treatment of numerous AK lesions in a region of the skin, termed field cancerization. It involves the application of a photosensitizer to the skin followed by illumination with a strong light source. Topical creams, such as 1379:

In terms of treatment, a number of medications are being studied. Resiquimod is a TLR 7/8 agonist that works similarly to imiquimod, but is 10 to 100 times more potent; when used to treat AK lesions, complete response rates have range from 40 to 74%.

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percents for women in this same study were 37% and 12% respectively). Furthermore, the use of sunscreen (SPF 17 or higher) has been found to significantly reduce the development of AK lesions, and also promotes the regression of existing lesions.

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of therapy is 60 to 90 days with twice daily application. Treatment of facial AK with diclofenac gel led to complete lesion resolution in 40% of cases. Common side effects include dryness, itching, redness, and rash at the site of application.

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Lawrence N, Cox SE, Cockerell CJ, Freeman RG, Cruz PD (February 1995). "A comparison of the efficacy and safety of Jessner's solution and 35% trichloroacetic acid vs 5% fluorouracil in the treatment of widespread facial actinic keratoses".

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Nelson MA, Einspahr JG, Alberts DS, Balfour CA, Wymer JA, Welch KL, Salasche SJ, Bangert JL, Grogan TM, Bozzo PO (September 1994). "Analysis of the p53 gene in human precancerous actinic keratosis lesions and squamous cell cancers".

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Thai KE, Fergin P, Freeman M, Vinciullo C, Francis D, Spelman L, Murrell D, Anderson C, Weightman W, Reid C, Watson A, Foley P (September 2004). "A prospective study of the use of cryosurgery for the treatment of actinic keratoses".

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was found to be safe, well tolerated and moderately effective in chemoprophylaxis for skin cancers in kidney transplant patients. Acitretin is a viable treatment option for organ transplant patients according to expert opinion.

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of 14.1 and 6.5, respectively), and AKs are uncommon in dark-skinned people of African descent. Other phenotypic features seen in fair-skinned individuals that are associated with an increased propensity to develop AKs include:

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can be removed with a curette. Tissue can be evaluated histopathologically under the microscope, but specimens acquired using this technique are not often adequate to determine whether a lesion is invasive or intraepidermal.

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Patel G, Armstrong AW, Eisen DB (December 2014). "Efficacy of photodynamic therapy vs other interventions in randomized clinical trials for the treatment of actinic keratoses: a systematic review and meta-analysis".

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Human papillomavirus (HPV): The role of HPV in the development of AK remains unclear, but evidence suggests that infection with the betapapillomavirus type of HPV may be associated with an increased likelihood of

1187:: Excision should be reserved for cases when the AK is a thick, horny papule, or when deeper invasion is suspected and histopathologic diagnosis is necessary. It is a rarely utilized technique for AK treatment. 850:

such as hats, sunglasses, long-sleeved shirts, long skirts, or trousers. “Consider taking 10 micrograms of vitamin D a day if you always cover up outdoors. This is because you may not get enough vitamin D from

464:, as well as other molecules associated with inflammation. Eventually, over time these changes lead to the formation of AKs. Several predictors for increased AK risk from UV radiation have been identified: 331:: When an AK forms on the lip, it is called actinic cheilitis. This usually presents as a rough, scaly patch on the lip, often accompanied by the sensation of dry mouth and symptomatic splitting of the lips. 3646:

Rosen RH, Gupta AK, Tyring SK (March 2012). "Dual mechanism of action of ingenol mebutate gel for topical treatment of actinic keratoses: rapid lesion necrosis followed by lesion-specific immune response".

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Gupta AK, Davey V, Mcphail H (October 2005). "Evaluation of the effectiveness of imiquimod and 5-fluorouracil for the treatment of actinic keratosis: Critical review and meta-analysis of efficacy studies".

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Drake LA, Ceilley RI, Cornelison RL, Dobes WL, Dorner W, Goltz RW, Graham GF, Lewis CW, Salasche SJ, Turner ML (January 1995). "Guidelines of care for actinic keratoses. Committee on Guidelines of Care".

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Röwert-Huber J, Patel MJ, Forschner T, Ulrich C, Eberle J, Kerl H, Sterry W, Stockfleth E (May 2007). "Actinic keratosis is an early in situ squamous cell carcinoma: a proposal for reclassification".

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Kang S, Goldfarb MT, Weiss JS, Metz RD, Hamilton TA, Voorhees JJ, Griffiths CE (July 2003). "Assessment of adapalene gel for the treatment of actinic keratoses and lentigines: a randomized trial".

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that can manifest as AKs or other neoplastic growths. With years of sun damage, it is possible to develop multiple AKs in a single area on the skin. This condition is termed field cancerization.

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of time. During this time the photosensitizer accumulates in the target cells within the AK lesion. The dressings are then removed and the lesion is treated with light at a specified wavelength.

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Engel A, Johnson ML, Haynes SG (January 1988). "Health effects of sunlight exposure in the United States. Results from the first National Health and Nutrition Examination Survey, 1971-1974".

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Diagnostically, researchers are investigating the role of novel biomarkers to assist in determining which AKs are more likely to develop into cutaneous or metastatic SCC. Upregulation of

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Pirard D, Vereecken P, Mélot C, Heenen M (November 2005). "Three percent diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses: a meta-analysis of the recent studies".

3290:"Network meta-analysis of the outcome 'participant complete clearance' in nonimmunosuppressed participants of eight interventions for actinic keratosis: a follow-up on a Cochrane review" 4853:

Gupta AK, Cooper EA, Feldman SR, Fleischer AB (August 2002). "A survey of office visits for actinic keratosis as reported by NAMCS, 1990-1999. National Ambulatory Medical Care Survey".

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to act as a protective factor against UVB radiation. It is being studied to determine its efficacy in preventing AKs in organ transplant patients who are on immunosuppressive therapy.

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Akay BN, Kocyigit P, Heper AO, Erdem C (December 2010). "Dermatoscopy of flat pigmented facial lesions: diagnostic challenge between pigmented actinic keratosis and lentigo maligna".

1127:(−195.8 °C) is the most commonly used destructive therapy for the treatment of AK in the United States. It is a well-tolerated office procedure that does not require anesthesia. 304:

or rough papule or plaque, often adherent to an erythematous base. Classic AKs can progress to become HAKs, and HAKs themselves can be difficult to distinguish from malignant lesions.

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Untreated AKs follow one of three paths: they can either persist as AKs, regress, or progress to invasive skin cancer, as AK lesions are considered to be on the same continuum with

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formation in DNA and RNA, leading to significant cellular mutations. In particular, mutations in the p53 tumor suppressor gene have been found in 30–50% of AK lesion skin samples.

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Iyer S, Friedli A, Bowes L, Kricorian G, Fitzpatrick RE (February 2004). "Full face laser resurfacing: therapy and prophylaxis for actinic keratoses and non-melanoma skin cancer".

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Berker, D.; McGregor, J.M.; Mohd Mustapa, M.F.; Exton, L.S.; Hughes, B.R.; McHenry, P.M.; Gibbon, K.; Buckley, D.A.; Nasr, I.; Duarte Williamson, C.E.; Swale, V.J. (January 2017).

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Zalaudek I, Ferrara G, Leinweber B, Mercogliano A, D'Ambrosio A, Argenziano G (December 2005). "Pitfalls in the clinical and dermoscopic diagnosis of pigmented actinic keratosis".

1372:(Serpins) is also being investigated. SerpinA1 was found to be elevated in the keratinocytes of SCC cell lines, and SerpinA1 upregulation was correlated with SCC tumor progression 307:

Atrophic: Atrophic AKs lack an overlying scale, and therefore appear as a nonpalpable change in color (or macule). They are often smooth and red and are less than 10mm in diameter.

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Taguchi M, Watanabe S, Yashima K, Murakami Y, Sekiya T, Ikeda S (October 1994). "Aberrations of the tumor suppressor p53 gene and p53 protein in solar keratosis in human skin".

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Pigmented AKs: gray to brown dots or globules surrounding follicular openings, and annular-granular rhomboidal structures; often difficult to differentiate from lentigo maligna.

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may show a loss of polarity, pleomorphism, and anaplasia. Some irregular downward proliferation into the uppermost dermis may be observed, but does not represent frank invasion.

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Non-pigmented AKs: linear or wavy vascular patterning, or a "strawberry pattern," described as unfocused vessels between hair follicles, with white-haloed follicular openings.

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Lebwohl M, Shumack S, Stein Gold L, Melgaard A, Larsson T, Tyring SK (June 2013). "Long-term follow-up study of ingenol mebutate gel for the treatment of actinic keratoses".

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have been studied in the treatment of AK with modest results, and the American Academy of Dermatology does not currently recommend this as first-line therapy. Treatment with

766:: Intercellular clefts or lacunae in the lowermost epidermal layer that result from anaplastic changes; these produce dyskeratotic cells with disrupted intercellular bridges. 4991:

Marks R, Jolley D, Lectsas S, Foley P (January 1990). "The role of childhood exposure to sunlight in the development of solar keratoses and non-melanocytic skin cancer".

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Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version".

1368:(MMP) is seen in many different types of cancers, and the expression and production of MMP-7 in particular has been found to be elevated in SCC specifically. The role of 989:

Topical medications are often recommended for areas where multiple or ill-defined AKs are present, as the medication can easily be used to treat a relatively large area.

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Normal skin (left) and actinic keratosis (right) with the defining characteristic of atypical basal keratinocytes that do not involve the full thickness of the epidermis.

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There are some data that in individuals with a history of non-melanoma skin cancer, a low-fat diet can serve as a preventative measure against future actinic keratoses.

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Hensen P, Müller ML, Haschemi R, Ständer H, Luger TA, Sunderkötter C, Schiller M (2009). "Predisposing factors of actinic keratosis in a North-West German population".

6702: 1205:: Dermabrasion is useful in the treatment of large areas with multiple AK lesions. The process involves using a hand-held instrument to "sand" the skin, removing the 550:

interfere with DNA repair after sun exposure, thereby putting these individuals at higher risk for the development of AKs. Examples of such genetic disorders include

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Pigmented AK: Pigmented AKs are rare variants that often present as macules or plaques that are tan to brown in color. They can be difficult to distinguish from a

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radiation have been implicated as causes of AKs. UV-A radiation (wavelength 320–400 nm) reaches more deeply into the skin and can lead to the generation of

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Szeimies RM, Bichel J, Ortonne JP, Stockfleth E, Lee J, Meng TC (July 2008). "A phase II dose-ranging study of topical resiquimod to treat actinic keratosis".

5133:"[Nle4-D-Phe7]-alpha-melanocyte-stimulating hormone significantly increased pigmentation and decreased UV damage in fair-skinned Caucasian volunteers" 1376:. Further investigation into specific biomarkers could help providers better assess prognosis and determine best treatment approaches for particular lesions. 705:

On histologic examination, actinic keratoses usually show a collection of atypical keratinocytes with hyperpigmented or pleomorphic nuclei, extending to the

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Feldman SR, Fleischer AB, Williford PM, Jorizzo JL (January 1999). "Destructive procedures are the standard of care for treatment of actinic keratoses".

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Frost CA, Green AC, Williams GM (December 1998). "The prevalence and determinants of solar keratoses at a subtropical latitude (Queensland, Australia)".

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Physicians usually diagnose actinic keratosis by doing a thorough physical examination, through a combination of visual observation and touch. However a

1217:, necessitating a hospital stay. One-year clearance rates with dermabrasion treatment are as high as 96%, but diminish drastically to 54% at five years. 2136:

Bagazgoitia L, Cuevas J, Juarranz A (February 2010). "Expression of p53 and p16 in actinic keratosis, bowenoid actinic keratosis and Bowen's disease".

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are used in the treatment of various types of cancers, and are currently being investigated for potential use in the treatment and prevention of AKs.

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Werner RN, Sammain A, Erdmann R, Hartmann V, Stockfleth E, Nast A (September 2013). "The natural history of actinic keratosis: a systematic review".

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is disordered to varying degrees: there may be widening of the intracellular spaces, cytologic atypia such as abnormally large nuclei, and a mild

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explained by an absence of hair causing a larger proportion of scalp to be exposed to UV radiation if other sun protection measures are not taken.

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Cuellar F, Vilalta A, Puig S, Palou J, Salerni G, Malvehy J (June 2009) . "New dermoscopic pattern in actinic keratosis and related conditions".

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Bowenoid AK: Usually presents as a solitary, erythematous, scaly patch or plaque with well-defined borders. Bowenoid AKs are differentiated from

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Fleming P, Zhou S, Bobotsis R, Lynde C (2017). "Comparison of the Treatment Guidelines for Actinic Keratosis: A Critical Appraisal and Review".

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Actinic keratoses characteristically appear as thick, scaly, or crusty areas that often feel dry or rough. Size commonly ranges between 2 and 6

7196: 7043: 6142: 159:, but they can grow to be several centimeters in diameter. AKs are often felt before they are seen, and the texture is sometimes compared to 2908: 2841: 2678: 1644: 1577: 1426: 662:

size or location, the biopsy should sample tissue from the thickest area of the lesion, as SCCs are most likely to be detected in that area.

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McBride P, Neale R, Pandeya N, Green A (July 2007). "Sun-related factors, betapapillomavirus, and actinic keratoses: a prospective study".

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layer of the epidermis. Diamond fraises or wire brushes revolving at high speeds are used. The procedure can be quite painful and requires

1103:(Klisyri) was approved for medical use in the United States in December 2020, for the treatment of actinic keratosis on the face or scalp. 843:

Applying sunscreen at least 15 minutes before going outside, as this allows time for the sunscreen to be absorbed appropriately by the skin

144:, usually over the course of decades. Given their pre-cancerous nature, if left untreated, they may turn into a type of skin cancer called 1619: 4760:"Actinic keratoses: Natural history and risk of malignant transformation in the Veterans Affairs Topical Tretinoin Chemoprevention Trial" 2671:

Clinical practice guide: basal cell carcinoma, squamous cell carcinoma (and related lesions): a guide to clinical management in Australia

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Quaedvlieg PJ, Tirsi E, Thissen MR, Krekels GA (Jul–Aug 2006). "Actinic keratosis: how to differentiate the good from the bad ones?".

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advanced lesions. Cryotherapy is generally performed using an open-spray technique, wherein the AK is sprayed for several seconds.

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Lichenoid: Demonstrate a band-like lymphocytic infiltrate in the papillary dermis, directly beneath the dermal-epidermal junction.

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induces mutations in the keratinocytes of the epidermis, promoting the survival and proliferation of these atypical cells. Both

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may be necessary when the keratosis is large in diameter, thick, or bleeding, in order to make sure that the lesion is not a

500:

Fair-skinned individuals have a significantly increased risk of developing AKs when compared to olive-skinned individuals (

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of the p53 pathway can thus result in unchecked replication of dysplastic keratinocytes, thereby serving as a source of

4481:

Coleman WP, Yarborough JM, Mandy SH (January 1996). "Dermabrasion for prophylaxis and treatment of actinic keratoses".

3997: 897: 163:. They may be dark, light, tan, pink, red, a combination of all these, or have the same color as the surrounding skin. 6760: 6542: 6537: 6468: 6003: 5534: 5489: 4956:

Green A, Beardmore G, Hart V, Leslie D, Marks R, Staines D (December 1988). "Skin cancer in a Queensland population".

4712:

Marks R, Rennie G, Selwood TS (April 1988). "Malignant transformation of solar keratoses to squamous cell carcinoma".

4062:"Athenex Announces FDA Approval of Klisyri (Tirbanibulin) for the Treatment of Actinic Keratosis on the Face or Scalp" 3339:"Effectiveness of 5-fluorouracil treatment for actinic keratosis--a systematic review of randomized controlled trials" 571: 358:

should raise concern for malignancy. Specifically, clinical findings suggesting an increased risk of progression to

7130: 6765: 6564: 6356: 6076: 2702: 936: 1306:

Squamous cell carcinoma of the nose. This skin cancer can develop from actinic keratoses if they are not treated.

908: 893: 591:(SCC) but both diseases can present similarly upon physical exam and can be difficult to distinguish clinically. 7048: 6669: 6611: 6278: 1968:

Rosen T, Lebwohl MG (January 2013). "Prevalence and awareness of actinic keratosis: barriers and opportunities".

1365: 359: 145: 7125: 7120: 7053: 6875: 6478: 6121: 5767: 5704: 5599: 5257: 2455:

Weissenborn SJ, Nindl I, Purdie K, Harwood C, Proby C, Breuer J, Majewski S, Pfister H, Wieland U (July 2005).

2023:

Butani AK, Butani A, Arbesfeld DM, Schwartz RA (April 2005). "Premalignant and early squamous cell carcinoma".

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is ineffective as treatment for reducing the number of AKs. For secondary prevention of AK, systemic, low-dose

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The most important cause of AK formation is solar radiation, through a variety of mechanisms. Mutation of the

4029: 3222:"Cryosurgery combined with topical interventions for actinic keratosis: a systematic review and meta-analysis" 918: 1325:

Recurrence: Recurrence rates after 1 year for single AK lesions that have regressed range between 15 and 53%.

6993: 6822: 6648: 6616: 6386: 6081: 5800: 5772: 5402: 2962:

Peris K, Micantonio T, Piccolo D, Fargnoli MC (November 2007). "Dermoscopic features of actinic keratosis".

1311: 847: 606: 588: 443: 375:

tumor suppressor gene, induced by UV radiation, has been identified as a crucial step in AK formation. This

171: 2058:

Yu RC, Pryce DW, Macfarlane AW, Stewart TW (May 1991). "A histopathological study of 643 cutaneous horns".

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in order to provide sufficient tissue for diagnosis; ideally, it would extend to the mid-reticular dermis.

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Regression: Reported regression rates for single AK lesions have ranged between 15 and 63% after one year.

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including avoidance of sun exposure. Furthermore, they should be avoided in individuals with a history of

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is a topical immune-enhancing agent licensed for the treatment of genital warts. Imiquimod stimulates the

1006: 412: 99: 3682: 6944: 6919: 6641: 6263: 6190: 5878: 5412: 5392: 5131:

Barnetson RS, Ooi TK, Zhuang L, Halliday GM, Reid CM, Walker PC, Humphrey SM, Kleinig MJ (August 2006).

3464:"British Association of Dermatologists' guidelines for the care of patients with actinic keratosis 2017" 2673:. Cancer Council Australia., Australian Cancer Network. Sydney, N.S.W.: Cancer Council Australia. 2008. 1164: 829: 689: 551: 376: 148:. Untreated lesions have up to a 20% risk of progression to squamous cell carcinoma, so treatment by a 4567:

Massey RA, Eliezri YD (June 1999). "A case report of laser resurfacing as a skin cancer prophylaxis".

7259: 7015: 6988: 6983: 6978: 6739: 6636: 6458: 5609: 5407: 5382: 2790:"Prevalence of actinic keratosis and its risk factors in the general population: the Rotterdam Study" 1279: 1259: 1156: 734: 618: 614: 419: 187: 31: 5320: 817:

Avoid sun exposure during noontime hours between 10:00 AM and 2:00 PM when UV light is most powerful

7181: 6939: 6860: 6490: 6331: 6268: 6243: 6217: 6071: 6049: 5644: 5604: 5524: 5514: 5246: 1210: 638: 622: 301: 230: 213: 221: 170:

If clinical examination findings are not typical of AK and the possibility of in situ or invasive

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Moy RL (January 2000). "Clinical presentation of actinic keratoses and squamous cell carcinoma".

1595: 179: 6865: 6401: 3261:

Robins P, Gupta AK (August 2002). "The use of topical fluorouracil to treat actinic keratosis".

3145: 485: 395:

growth and the development of AK, as well as possible progression from AK to skin cancer. Other

335: 273: 2457:"Human papillomavirus-DNA loads in actinic keratoses exceed those in non-melanoma skin cancers" 1572:. Fitzpatrick, Thomas B. (Thomas Bernard), 1919-2003., Kang, Sewon (Ninth ed.). New York. 943: 7137: 7020: 6554: 6549: 6238: 5944: 5820: 5815: 5694: 5668: 5594: 5584: 5422: 5297: 5268: 5195: 5154: 5105: 5070: 5008: 4973: 4935: 4897: 4862: 4827: 4781: 4729: 4691: 4655: 4619: 4584: 4541: 4498: 4463: 4420: 4384: 4335: 4291: 4255: 4204: 4169: 4134: 4107: 3942: 3906: 3871: 3814: 3776: 3733: 3664: 3628: 3589: 3523: 3493: 3485: 3441: 3406: 3360: 3311: 3270: 3243: 3194: 3071: 3022: 2979: 2944: 2904: 2873: 2837: 2811: 2759: 2684: 2674: 2644: 2602: 2561: 2513: 2478: 2434: 2395: 2341: 2295: 2239: 2212: 2153: 2118: 2075: 2040: 1985: 1945: 1896: 1857: 1808: 1764: 1704: 1677: 1640: 1583: 1573: 1545: 1512: 1490: 1447: 1422: 1287: 1184: 1059: 533: 454: 396: 328: 70: 4918:

Salasche SJ (January 2000). "Epidemiology of actinic keratoses and squamous cell carcinoma".

776:

Pigmented: Show pigmentation in the basal layer of the epidermis, similar to a solar lentigo.

399:

that have been associated with the development of AK include the expression of p16, p14, the

297:. They are usually 2–6mm in diameter but can sometimes reach several centimeters in diameter. 7186: 6605: 6586: 6336: 6185: 6091: 6039: 5909: 5684: 5619: 5185: 5144: 5097: 5060: 5050: 5000: 4965: 4927: 4889: 4819: 4771: 4721: 4683: 4647: 4611: 4576: 4533: 4490: 4455: 4412: 4374: 4366: 4327: 4283: 4245: 4235: 4196: 4161: 4099: 3934: 3898: 3861: 3853: 3806: 3768: 3723: 3656: 3620: 3579: 3475: 3398: 3350: 3301: 3233: 3186: 3061: 3014: 2971: 2936: 2801: 2788:

Flohil SC, van der Leest RJ, Dowlatshahi EA, Hofman A, de Vries E, Nijsten T (August 2013).

2751: 2636: 2592: 2553: 2505: 2468: 2426: 2385: 2377: 2333: 2287: 2202: 2192: 2145: 2110: 2067: 2032: 1977: 1935: 1888: 1847: 1800: 1756: 1669: 1480: 1046: 1040: 820:

Minimize all time in the sun, since UV exposure occurs even in the winter and on cloudy days

750: 710: 678: 547: 461: 198:, may require daily application to affected skin areas over a typical time course of weeks. 1695:

Stockfleth E, Kerl H (Nov–Dec 2006). "Guidelines for the management of actinic keratoses".

1245:

laser has been recommended for extensive actinic cheilitis that has not responded to 5-FU.

281:

Actinic keratoses can have various clinical presentations, often characterized as follows:

7243: 7086: 7030: 7000: 6559: 6483: 6463: 6433: 6321: 6248: 5919: 5634: 5479: 5417: 2716: 1302: 1206: 1124: 726: 322: 17: 2557: 5308: 5004: 4152:

Lubritz RR, Smolewski SA (November 1982). "Cryosurgery cure rate of actinic keratoses".

862:, and the CDC currently recommends routine vaccination in all children at age 11 or 12. 770:

of the epidermis, in the background of a lesion that is otherwise consistent with an AK.

7212: 6890: 6495: 6381: 6371: 6288: 5830: 5658: 5190: 5173: 5065: 5038: 4494: 4379: 4354: 4250: 4223: 3866: 3841: 2390: 2365: 2207: 2180: 2071: 1852: 1835: 1485: 1468: 1291: 1230: 714: 555: 543: 311: 247: 5251: 4969: 4725: 4615: 4459: 4200: 4165: 7253: 7076: 7010: 6366: 6341: 6296: 6258: 6126: 5993: 5853: 5805: 5737: 5709: 5117: 5101: 4793: 4651: 4580: 4416: 4287: 3938: 3355: 3338: 3323: 3034: 3018: 2975: 2640: 2509: 2473: 2456: 2430: 2307: 2291: 2149: 1940: 1923: 1892: 1804: 1381: 1267: 1263: 1254: 1226: 1021: 746: 718: 626: 388: 380: 318: 186:

examination of the lesional tissue. Multiple treatment options for AK are available.

149: 5020: 4839: 4741: 4553: 4432: 4303: 3954: 3826: 3372: 3206: 2991: 2771: 2656: 2165: 2087: 1908: 1820: 1776: 7081: 6800: 6595: 6590: 6311: 5883: 5863: 5678: 5673: 5663: 5504: 4510: 4370: 4331: 3772: 3119: 2896: 2525: 1632: 1202: 1100: 998: 785: 763: 730: 697: 674: 666: 446:, which in turn can damage cell membranes, signaling proteins, and nucleic acids. 258: 191: 112: 3745: 3418: 2010:

Epithelial precancerous lesions. In: Fitzpatrick's Dermatology in General Medicine

5262: 4758:

Criscione VD, Weinstock MA, Naylor MF, Luque C, Eide MJ, Bingham SF (June 2009).

2940: 2337: 6711: 6600: 6441: 6346: 6171: 5873: 5539: 5292: 2597: 2580: 2197: 1722: 1143: 1002: 859: 833: 706: 630: 584: 521: 460:

UV radiation has also been shown to cause elevated inflammatory markers such as

431: 201: 156: 141: 116: 75: 6680: 5273: 4687: 3857: 3660: 3624: 2755: 2114: 1981: 1348:

features, and immunosuppression can also contribute to the development of AKs.

300:

Hypertrophic (or hyperkeratotic): Hypertrophic AKs (HAKs) appears as a thicker

6659: 6306: 6147: 6024: 5742: 5714: 5484: 5303: 5236: 4224:"Review of photodynamic therapy in actinic keratosis and basal cell carcinoma" 3810: 3402: 2381: 2036: 1587: 1385: 1214: 722: 501: 392: 384: 355: 351: 347: 239: 205:

close monitoring, at a time when treatment is likely to have a high cure rate.

129: 121: 57: 3489: 3190: 2688: 6967: 6730: 6715: 6351: 6301: 6065: 5652: 5624: 5529: 5364: 4931: 4103: 3842:"Guidelines of care for the management of cutaneous squamous cell carcinoma" 3710:

Lebwohl M, Swanson N, Anderson LL, Melgaard A, Xu Z, Berman B (March 2012).

3066: 3049: 1673: 1397: 1393: 1345: 1191: 1088: 1084: 1076: 1072: 1025: 1017: 642: 610: 594: 451: 339: 243: 195: 183: 160: 109: 104: 5199: 5158: 5149: 5132: 5109: 5074: 4939: 4901: 4866: 4831: 4785: 4623: 4588: 4545: 4424: 4388: 4339: 4295: 4259: 4138: 4111: 3946: 3910: 3875: 3818: 3780: 3737: 3668: 3632: 3593: 3584: 3567: 3527: 3497: 3445: 3410: 3364: 3315: 3274: 3247: 3198: 3075: 3026: 2983: 2948: 2815: 2763: 2517: 2482: 2399: 2299: 2243: 2216: 2157: 2122: 2044: 1989: 1900: 1861: 1812: 1768: 1723:"Actinic keratosis - Symptoms, diagnosis and treatment | BMJ Best Practice" 1708: 1681: 1549: 1494: 5055: 5012: 4977: 4893: 4733: 4695: 4659: 4502: 4467: 4208: 4173: 3840:

Kim JY, Kozlow JH, Mittal B, Moyer J, Olenecki T, Rodgers P (March 2018).

3728: 3711: 2648: 2606: 2565: 2438: 2345: 2079: 1949: 6574: 6514: 6376: 5998: 5978: 5914: 5868: 5810: 5747: 5689: 5509: 5458: 5387: 5039:"Squamous cell carcinoma of the skin: Emerging need for novel biomarkers" 3902: 2806: 2789: 646: 294: 254: 6453: 6175: 6029: 5939: 5858: 5845: 5795: 5724: 5448: 5443: 5438: 4776: 4759: 4240: 2868:

Schaffer (2012). Jean L. Bolognia; Joseph L. Jorizzo; Julie V. (eds.).

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if you can. Unsourced or poorly sourced material may be challenged and

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area of thick, scaly, or crusty skin. Actinic keratosis is a disorder (

5219: 4823: 4537: 3568:"Imiquimod for actinic keratosis: systematic review and meta-analysis" 3480: 3463: 3306: 3289: 3238: 3221: 1760: 713:. A "flag sign" is often described, referring to alternating areas of 5787: 5732: 5499: 5494: 5468: 5377: 5231: 5174:"Nonsurgical innovations in the treatment of nonmelanoma skin cancer" 2181:"Actinic Keratosis and Non-Invasive Diagnostic Techniques: An Update" 1534:"Actinic keratosis: how to differentiate the good from the bad ones?" 1369: 1238: 670: 658: 598: 580: 175: 745:

Hypertrophic: Notable for marked hyperkeratosis, often with evident

4125:

Zimmerman EE, Crawford P (December 2012). "Cutaneous cryosurgery".

1116: 7173: 5453: 4090:

Dinehart SM (January 2000). "The treatment of actinic keratoses".

1301: 1142: 1115: 696: 688: 570: 484: 408: 272: 220: 212: 1314:(SCC). AK lesions that regress also have the potential to recur. 601:

or excision may be necessary to definitively distinguish AK from

7071: 7063: 6578: 6034: 5553: 5372: 3514:

Correale CE (2002). "Actinic keratoses: new treatment options".

2278:

Rossi R, Mori M, Lotti T (September 2007). "Actinic keratosis".

447: 439: 435: 400: 363:

concerning features warrant biopsy for diagnostic confirmation.

229:

Actinic keratoses (AKs) most commonly present as a white, scaly

137: 6684: 6405: 5324: 4353:

Gupta AK, Paquet M, Villanueva E, Brintnell W (December 2012).

2138:

Journal of the European Academy of Dermatology and Venereology

1749:

Journal of the European Academy of Dermatology and Venereology

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AKs are one of the most common dermatologic lesions for which

872: 837: 404: 372: 133: 1922:

Taylor CR, Stern RS, Leyden JJ, Gilchrest BA (January 1990).

1352:

men ages 20–29 develop AK compared to 79% of men ages 60–69.

840:

light, at least every 2 hours and after swimming or sweating

1151:

one week after exposure. Patient has light skin, blue eyes.

1050:

which has been used as a traditional remedy for keratosis.

669:

is performed, it should extend through to the level of the

1266:

in a once-daily application for a minimum of 3 weeks; 70%

1147:

Interim result of phototherapy for actinic keratosis with

277:

Hyperkeratotic actinic keratosis on lip ("cutaneous horn")

174:

cannot be excluded based on clinical examination alone, a

285:

Classic (or common): Classic AKs present as white, scaly

2783: 2781: 293:

or plaques of various thickness, often with surrounding

4602:

Monheit GD (July 2001). "Medium-depth chemical peels".

3337:

Askew DA, Mickan SM, Soyer HP, Wilkinson D (May 2009).

2581:"Reduction of solar keratoses by regular sunscreen use" 1532:

Quaedvlieg PJ, Tirsi E, Thissen MR, Krekels GA (2006).

904: 681:

when the entire length of the punch blade is utilized.

3220:

Heppt MV, Steeb T, Ruzicka T, Berking C (April 2019).

2450: 2448: 1135:

hyperpigmentation; and destruction of healthy tissue.

1120:

Cryosurgery instrument used to treat actinic keratoses

7227: 729:

are often seen. The normal ordered maturation of the

609:. In addition to SCCs, AKs can be mistaken for other 5209: 1384:

is a drug that induces the production of melanin by

140:

gets damaged by UV radiation from the sun or indoor

7205: 7171: 7110: 7103: 7062: 7029: 6966: 6957: 6912: 6889: 6821: 6738: 6729: 6722: 6629: 6573: 6513: 6504: 6440: 6320: 6287: 6231: 6216: 6207: 6164: 6135: 6114: 6105: 6058: 6017: 5986: 5975: 5968: 5957: 5902: 5844: 5786: 5723: 5643: 5572: 5561: 5552: 5467: 5431: 5363: 5356: 5283: 5213: 5172:Amini S, Viera MH, Valins W, Berman B (June 2010). 2964:

Journal der Deutschen Dermatologischen Gesellschaft

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Multiple lesions of actinic keratosis on the scalp.

69: 47: 42: 4222:Ericson MB, Wennberg AM, Larkö O (February 2008). 4187:Kuflik EG (December 1994). "Cryosurgery updated". 2179:Casari, A; Chester, J; Pellacani, G (March 2018). 5351:Diseases of the skin and appendages by morphology 5178:The Journal of Clinical and Aesthetic Dermatology 1840:The Journal of Clinical and Aesthetic Dermatology 257:changes, resulting in a proliferation of mutated 2579:Thompson SC, Jolley D, Marks R (October 1993). 1873: 1871: 338:by degree of epithelial involvement as seen on 167:most people who have an AK have more than one. 65:Actinic keratosis seen on the back of the hands 4958:Journal of the American Academy of Dermatology 4920:Journal of the American Academy of Dermatology 4640:Journal of the American Academy of Dermatology 4448:Journal of the American Academy of Dermatology 4189:Journal of the American Academy of Dermatology 4154:Journal of the American Academy of Dermatology 4092:Journal of the American Academy of Dermatology 4064:(Press release). Athenex Inc. 15 December 2020 3891:Journal of the American Academy of Dermatology 3846:Journal of the American Academy of Dermatology 3649:Journal of the American Academy of Dermatology 3613:Journal of the American Academy of Dermatology 3054:Journal of the American Academy of Dermatology 2103:Journal of the American Academy of Dermatology 1970:Journal of the American Academy of Dermatology 1928:Journal of the American Academy of Dermatology 1662:Journal of the American Academy of Dermatology 1527: 1525: 903:Please review the contents of the section and 450:radiation (wavelength 290–320 nm) causes 182:can be considered for definitive diagnosis by 7143:Inflammatory linear verrucous epidermal nevus 6696: 6417: 5836:Pityriasis lichenoides et varioliformis acuta 5336: 4913: 4911: 4805: 4803: 2836:(12th ed.). Philadelphia, PA: Elsevier. 2366:"Actinic keratosis: rationale and management" 1509:Fitzpatrick's Dermatology in General Medicine 1446:. J. B. Lippincott and Company. p. 512. 587:. Actinic keratosis may progress to invasive 575:Actinic keratosis, left upper paraspinal back 8: 5490:Dermatofibroma (benign fibrous histiocytoma) 3712:"Ingenol mebutate gel for actinic keratosis" 3434:The Medical Letter on Drugs and Therapeutics 1924:"Photoaging/photodamage and photoprotection" 1444:Logan's Medical and Scientific Abbreviations 1319:idea that these lesions are closely related. 217:Close-up view of an actinic keratosis lesion 6899:Aggressive digital papillary adenocarcinoma 4359:The Cochrane Database of Systematic Reviews 1836:"Actinic keratoses: a comprehensive update" 832:ratings 30 or greater that also block both 489:Actinic keratoses on the forehead of a male 132:people and those who are frequently in the 7107: 6963: 6935:Primary cutaneous adenoid cystic carcinoma 6735: 6726: 6703: 6689: 6681: 6510: 6424: 6410: 6402: 6213: 6111: 5983: 5972: 5965: 5569: 5558: 5360: 5343: 5329: 5321: 5210: 1600:: CS1 maint: location missing publisher ( 1421:. St. Louis: Mosby. pp. Chapter 108. 1417:Rapini RP, Bolognia J, Jorizzo JL (2007). 1262:(TCA) alone or at 35% in combination with 773:Epidermolytic: With granular degeneration. 56: 39: 5189: 5148: 5064: 5054: 4775: 4378: 4249: 4239: 4228:Therapeutics and Clinical Risk Management 3865: 3727: 3583: 3566:Hadley G, Derry S, Moore RA (June 2006). 3479: 3390:Journal of Cutaneous Medicine and Surgery 3354: 3305: 3237: 3178:Journal of Cutaneous Medicine and Surgery 3065: 2891: 2889: 2805: 2596: 2472: 2389: 2206: 2196: 1939: 1851: 1484: 1024:through the release and up-regulation of 7153:Pigmented hairy epidermal nevus syndrome 5137:The Journal of Investigative Dermatology 5037:Kivisaari A, Kähäri VM (November 2013). 3572:The Journal of Investigative Dermatology 3432:"New treatments for actinic keratoses". 2794:The Journal of Investigative Dermatology 2461:The Journal of Investigative Dermatology 2411: 2409: 2364:Dodds A, Chia A, Shumack S (June 2014). 2326:The Journal of Investigative Dermatology 2319: 2317: 793:parakeratosis known as the "flag sign." 635:erosive pustular dermatosis of the scalp 7234: 7192:Unilateral palmoplantar verrucous nevus 2832:James WD, Elston DM, Berger TG (2016). 2622: 2620: 2618: 2616: 2539: 2537: 2535: 1409: 253:Photoaging leads to an accumulation of 7197:Zosteriform speckled lentiginous nevus 7044:Keratoacanthoma centrifugum marginatum 6143:Disseminated intravascular coagulation 5032: 5030: 4951: 4949: 4753: 4751: 4707: 4705: 4085: 4083: 4081: 4079: 3543: 3541: 3539: 3537: 3170: 3168: 3166: 3089: 3087: 3085: 2827: 2825: 2694: 2359: 2357: 2355: 2273: 1593: 51:Solar keratosis, senile keratosis (SK) 4355:"Interventions for actinic keratoses" 3792: 3790: 3605: 3603: 3561: 3559: 3509: 3507: 3457: 3455: 3120:"Actinic keratoses (solar keratoses)" 3050:"The scientific basis of skin cancer" 2922: 2920: 2872:(3rd ed.). : Elsevier Saunders. 2863: 2861: 2859: 2857: 2855: 2853: 2271: 2269: 2267: 2265: 2263: 2261: 2259: 2257: 2255: 2253: 2003: 2001: 1999: 1963: 1961: 1959: 1563: 1561: 1559: 1237:) or erbium:yttrium aluminum garnet ( 7: 6813:Nevoid basal-cell carcinoma syndrome 3343:International Journal of Dermatology 2721:The Lecturio Medical Concept Library 2558:10.1001/archderm.1988.01670010036018 2280:International Journal of Dermatology 1881:International Journal of Dermatology 1467:Prajapati V, Barankin B (May 2008). 407:-related apoptosis-inducing ligand ( 6665:Photosensitivity with HIV infection 5005:10.5694/j.1326-5377.1990.tb124456.x 3799:Archives of Dermatological Research 3716:The New England Journal of Medicine 2585:The New England Journal of Medicine 1396:, and anti-EGFR antibodies such as 387:arrest when DNA or RNA is damaged. 5925:Postinflammatory hyperpigmentation 5090:The British Journal of Dermatology 5043:World Journal of Clinical Oncology 4812:The British Journal of Dermatology 4495:10.1111/j.1524-4725.1996.tb00565.x 4405:The British Journal of Dermatology 3294:The British Journal of Dermatology 3288:Gupta AK, Paquet M (August 2013). 3226:The British Journal of Dermatology 3007:The British Journal of Dermatology 2629:The British Journal of Dermatology 2498:The British Journal of Dermatology 2072:10.1111/j.1365-2133.1991.tb00624.x 2060:The British Journal of Dermatology 1834:Ibrahim SF, Brown MD (July 2009). 1793:The British Journal of Dermatology 25: 5826:Transient acantholytic dermatosis 597:examination of the lesion from a 136:. They are believed to form when 128:These growths are more common in 27:Rough skin induced by UV exposure 7237: 7148:Linear verrucous epidermal nevus 6533:Hyperkeratotic actinic keratosis 5935:Idiopathic guttate hypomelanosis 5102:10.1111/j.1365-2133.2008.08615.x 4993:The Medical Journal of Australia 4581:10.1046/j.1524-4725.1999.08260.x 4417:10.1111/j.1365-2133.2008.08488.x 4288:10.1111/j.1600-0625.2008.00770.x 3939:10.1111/j.1399-0012.2004.00311.x 3356:10.1111/j.1365-4632.2009.04045.x 3019:10.1111/j.1365-2133.2010.10025.x 2976:10.1111/j.1610-0387.2007.06318.x 2641:10.1046/j.1365-2133.1998.02560.x 2510:10.1111/j.1365-2133.2007.07860.x 2474:10.1111/j.0022-202X.2005.23733.x 2292:10.1111/j.1365-4632.2007.03166.x 2150:10.1111/j.1468-3083.2009.03337.x 1893:10.1111/j.1365-4632.2004.02056.x 1805:10.1111/j.1365-2133.2012.10887.x 1390:Epidermal growth factor receptor 1001:(5-FU) destroys AKs by blocking 969: 877: 814:Limiting extent of sun exposure 701:Actinic keratosis, atrophic form 418:Evidence also suggests that the 7163:Phakomatosis pigmentokeratotica 5945:Hypopigmented mycosis fungoides 4882:European Journal of Dermatology 4274:5-aminolaevulinic acid patch". 3099:American Academy of Dermatology 2232:European Journal of Dermatology 1697:European Journal of Dermatology 1538:European Journal of Dermatology 641:, inflammatory dermatoses like 6432:Radiation-related disorders / 6186:Lichen sclerosis et atrophicus 5894:Subcorneal pustular dermatosis 5520:Infantile digital fibromatosis 4526:Lasers in Surgery and Medicine 4371:10.1002/14651858.CD004415.pub2 4332:10.1001/jamadermatol.2014.1253 4030:"FULL PRESCRIBING INFORMATION" 3773:10.1001/jamadermatol.2013.2766 3468:British Journal of Dermatology 1469:"Dermacase. Actinic keratosis" 905:add the appropriate references 1: 6925:Microcystic adnexal carcinoma 5778:Epidermolysis bullosa simplex 5615:Langerhans cell histiocytosis 4970:10.1016/s0190-9622(88)70270-4 4726:10.1016/s0140-6736(88)91658-3 4616:10.1016/s0733-8635(05)70282-5 4460:10.1016/s0190-9622(99)70526-8 4201:10.1016/s0190-9622(94)70261-6 4166:10.1016/s0190-9622(82)70143-4 3969:"Klisyri: FDA-Approved Drugs" 3146:"HPV Vaccine Recommendations" 2834:Andrews' Diseases of the Skin 2008:Duncan KO, Geisse JK (2008). 1270:(α-hydroxy acid); or solid CO 172:squamous cell carcinoma (SCC) 7158:Systematized epidermal nevus 6904:Extramammary Paget's disease 6474:Benign summer light eruption 6254:Systemic lupus erythematosus 6009:Systemic lupus erythematosus 5700:Systemic lupus erythematosus 4652:10.1016/0190-9622(95)90191-4 4039:Food and Drug Administration 4007:Food and Drug Administration 3975:Food and Drug Administration 2941:10.1001/archdermatol.2009.86 2431:10.1016/0304-3835(94)90234-8 2338:10.1111/1523-1747.ep12395643 2012:. McGraw-Hill. p. 1007. 1941:10.1016/0190-9622(90)70001-x 1620:Dorland's Medical Dictionary 6543:Pigmented actinic keratosis 6538:Lichenoid actinic keratosis 6469:Polymorphous light eruption 5535:Lymphangioma circumscriptum 3552:(Sixth ed.). Elsevier. 3048:Leffell DJ (January 2000). 2598:10.1056/nejm199310143291602 2198:10.3390/biomedicines6010008 890:reliable medical references 411:) and TRAIL receptors, and 7276: 7131:Nevus comedonicus syndrome 6766:Fibroepithelioma of Pinkus 6565:Chronic actinic dermatitis 6528:Atrophic actinic keratosis 6357:Mucous membrane pemphigoid 4688:10.1001/archderm.131.2.176 4072:– via GlobeNewswire. 3858:10.1016/j.jaad.2017.10.007 3661:10.1016/j.jaad.2010.12.038 3625:10.1016/j.jaad.2009.07.004 2903:(3rd ed.). Elsevier. 2756:10.1001/archderm.143.7.862 2115:10.1016/j.jaad.2005.08.052 2025:Clinics in Plastic Surgery 1982:10.1016/j.jaad.2012.09.052 1639:(3rd ed.). Elsevier. 1511:. (6th ed.). McGraw-Hill. 1507:Freedberg, et al. (2003). 1442:Logan CM, Rice MK (1987). 1392:(EGFR) inhibitors such as 1370:serin peptidase inhibitors 432:ultraviolet (UV) radiation 29: 18:Atrophic actinic keratosis 6670:Phototoxic tar dermatitis 6612:Cutis rhomboidalis nuchae 4195:(6): 925–44, quiz 944–6. 4127:American Family Physician 3811:10.1007/s00403-005-0601-9 3440:(1133): 57–8. June 2002. 3403:10.1007/s10227-005-0148-6 2382:10.1007/s13555-014-0049-y 2037:10.1016/j.cps.2004.11.001 1570:Fitzpatrick's dermatology 1473:Canadian Family Physician 1419:Dermatology: 2-Volume Set 1366:matrix metalloproteinases 1258:achieved with 35% to 50% 896:or relies too heavily on 828:Applying sunscreens with 725:and surrounding areas of 250:are also characteristic. 64: 55: 7126:Schimmelpenning syndrome 7121:Epidermal nevus syndrome 6876:Erythroplasia of Queyrat 6655:Favre–Racouchot syndrome 6479:Juvenile spring eruption 6122:Thrombocytopenic purpura 5768:Dermatitis herpetiformis 5753:Acute contact dermatitis 5705:Pityriasis rubra pilaris 5630:Wiskott–Aldrich syndrome 5600:Lichen simplex chronicus 5480:Epidermal inclusion cyst 4276:Experimental Dermatology 3927:Clinical Transplantation 3191:10.1177/1203475417708166 3095:"How to apply sunscreen" 2717:"Actinic Keratosis (AK)" 514:Light hair and eye color 30:Not to be confused with 6649:Chronic radiodermatitis 6617:Poikiloderma of Civatte 6387:Squamous-cell carcinoma 6382:Systemic histoplasmosis 5773:Porphyria cutanea tarda 5403:Squamous-cell carcinoma 4932:10.1067/mjd.2000.103342 4676:Archives of Dermatology 4104:10.1067/mjd.2000.103338 3516:Advances in Dermatology 3067:10.1067/mjd.2000.103340 2929:Archives of Dermatology 2901:Weedon's Skin Pathology 2744:Archives of Dermatology 2546:Archives of Dermatology 2370:Dermatology and Therapy 1674:10.1067/mjd.2000.103343 1637:Weedon's Skin Pathology 1312:squamous cell carcinoma 1286:, and in those who are 1194:(sometimes followed by 1167:(5-ALA), is indicated. 848:sun protective clothing 749:. Keratinocytes in the 677:usually extends to the 589:squamous cell carcinoma 444:reactive oxygen species 360:squamous cell carcinoma 146:squamous cell carcinoma 7006:Pilar sheath acanthoma 6362:Cicatricial pemphigoid 6279:Acne keloidalis nuchae 6274:Folliculitis decalvans 5150:10.1038/sj.jid.5700317 3585:10.1038/sj.jid.5700264 2701:: CS1 maint: others ( 1307: 1161:methyl aminolevulinate 1152: 1149:methyl aminolevulinate 1121: 1007:thymidylate synthetase 702: 694: 576: 490: 413:loss of heterozygosity 278: 226: 218: 6945:Malignant mixed tumor 6920:Merkel-cell carcinoma 6264:Loose anagen syndrome 6191:Necrobiosis lipoidica 6127:Actinic/solar purpura 5801:Insect bite reactions 5590:Seborrheic dermatitis 5413:Merkel-cell carcinoma 5393:Molluscum contagiosum 5056:10.5306/wjco.v4.i4.85 4894:10.1684/ejd.2009.0706 3729:10.1056/nejmoa1111170 1305: 1165:5-aminolevulinic acid 1146: 1119: 1054:Diclofenac sodium gel 825:Using sun protection 700: 692: 574: 552:xeroderma pigmentosum 517:Propensity to sunburn 488: 426:Ultraviolet radiation 377:tumor suppressor gene 276: 265:and hyperkeratotic). 224: 216: 7039:Generalized eruptive 7016:Seborrheic keratosis 6637:Radiation dermatitis 6459:Phytophotodermatitis 6087:Annulare centrifugum 5610:Glucagonoma syndrome 5408:Basal-cell carcinoma 5383:Seborrheic keratosis 4604:Dermatologic Clinics 4569:Dermatologic Surgery 4483:Dermatologic Surgery 3903:10.1067/mjd.2003.451 3550:Clinical Dermatology 2807:10.1038/jid.2013.134 1727:bestpractice.bmj.com 1568:Kang, Sewon (2019). 1260:trichloroacetic acid 1159:, including topical 1157:photodynamic therapy 1139:Photodynamic therapy 1036:Ingenol mebutate gel 735:chronic inflammatory 723:Epidermal thickening 619:basal cell carcinoma 615:seborrheic keratoses 420:human papillomavirus 188:Photodynamic therapy 90:), sometimes called 32:Seborrheic keratosis 7182:Nevus unius lateris 6940:Verrucous carcinoma 6491:Hydroa vacciniforme 6332:Aphthous stomatitis 6269:Lichen planopilaris 6244:Androgenic alopecia 6050:Fixed drug eruption 5625:Pemphigus foliaceus 5525:Granular cell tumor 1976:(1 Suppl 1): S2-9. 1615:"actinic keratosis" 1211:procedural sedation 1190:Shave excision and 1179:Surgical techniques 919:"Actinic keratosis" 639:pemphigus foliaceus 623:lichenoid keratosis 430:It is thought that 115:that is induced by 6930:Mucinous carcinoma 6871:Bowenoid papulosis 6352:Pemphigus vulgaris 6181:Granuloma annulare 6045:Carcinoid syndrome 5930:Tuberous sclerosis 5889:Coccidioidomycosis 5763:Bullous pemphigoid 5758:Pemphigus vulgaris 5690:Secondary syphilis 5580:Contact dermatitis 5284:External resources 4777:10.1002/cncr.24284 4610:(3): 413–25, vii. 4241:10.2147/TCRM.S1769 3690:Accessdate.fda.gov 3683:"Picato Gel label" 2723:. 12 November 2020 1308: 1290:or who are taking 1264:Jessner's solution 1196:electrodesiccation 1153: 1122: 993:Fluorouracil cream 703: 695: 613:lesions including 577: 528:Other risk factors 491: 279: 227: 219: 209:Signs and symptoms 7225: 7224: 7221: 7220: 7138:Nevus comedonicus 7099: 7098: 7095: 7094: 7021:Warty dyskeratoma 6953: 6952: 6881:Actinic keratosis 6678: 6677: 6625: 6624: 6555:Actinic granuloma 6550:Actinic cheilitis 6523:Actinic keratosis 6399: 6398: 6395: 6394: 6239:Telogen effluvium 6203: 6202: 6199: 6198: 6160: 6159: 6156: 6155: 6101: 6100: 5953: 5952: 5821:Lichen spinulosus 5816:Keratosis pilaris 5695:Mycosis fungoides 5595:Stasis dermatitis 5585:Atopic dermatitis 5548: 5547: 5423:Trichoepithelioma 5398:Actinic keratosis 5318: 5317: 5309:Actinic keratosis 4861:(2 Suppl): 8–13. 4824:10.1111/bjd.12420 4538:10.1002/lsm.20012 3481:10.1111/bjd.15107 3307:10.1111/bjd.12343 3239:10.1111/bjd.17435 3060:(1 Pt 2): 18–22. 2910:978-0-7020-3485-5 2843:978-0-323-31967-6 2680:978-0-9775060-6-4 2504:(Suppl 3): 8–12. 1761:10.1111/jdv.13180 1646:978-0-7020-3485-5 1579:978-0-07-183778-1 1428:978-1-4160-2999-1 1185:Surgical excision 1060:diclofenac sodium 978: 977: 954: 751:stratum malphigii 548:genetic disorders 534:Immunosuppression 481:Skin pigmentation 397:molecular markers 329:Actinic cheilitis 84:Actinic keratosis 81: 80: 43:Actinic keratosis 37:Medical condition 16:(Redirected from 7267: 7242: 7241: 7240: 7233: 7187:Patch blue nevus 7108: 7072:Verruca vulgaris 6964: 6861:Marjolin's ulcer 6849:Signet-ring-cell 6736: 6727: 6705: 6698: 6691: 6682: 6606:Peat fire cancer 6587:Erythema ab igne 6511: 6426: 6419: 6412: 6403: 6337:Oral candidiasis 6214: 6112: 6040:Erythema nodosum 5984: 5973: 5966: 5910:Tinea versicolor 5748:Bullous impetigo 5685:Pityriasis rosea 5620:Lichen sclerosus 5605:Darier's disease 5570: 5559: 5515:Kaposi's sarcoma 5361: 5345: 5338: 5331: 5322: 5211: 5204: 5203: 5193: 5169: 5163: 5162: 5152: 5128: 5122: 5121: 5085: 5079: 5078: 5068: 5058: 5034: 5025: 5024: 4988: 4982: 4981: 4953: 4944: 4943: 4915: 4906: 4905: 4877: 4871: 4870: 4850: 4844: 4843: 4807: 4798: 4797: 4779: 4755: 4746: 4745: 4709: 4700: 4699: 4670: 4664: 4663: 4634: 4628: 4627: 4599: 4593: 4592: 4564: 4558: 4557: 4521: 4515: 4514: 4478: 4472: 4471: 4443: 4437: 4436: 4399: 4393: 4392: 4382: 4365:(12): CD004415. 4350: 4344: 4343: 4320:JAMA Dermatology 4314: 4308: 4307: 4270: 4264: 4263: 4253: 4243: 4219: 4213: 4212: 4184: 4178: 4177: 4149: 4143: 4142: 4122: 4116: 4115: 4098:(1 Pt 2): 25–8. 4087: 4074: 4073: 4071: 4069: 4058: 4052: 4051: 4049: 4047: 4034: 4026: 4020: 4019: 4017: 4015: 4002: 3994: 3988: 3987: 3985: 3983: 3965: 3959: 3958: 3921: 3915: 3914: 3886: 3880: 3879: 3869: 3837: 3831: 3830: 3794: 3785: 3784: 3761:JAMA Dermatology 3756: 3750: 3749: 3731: 3707: 3701: 3700: 3698: 3696: 3687: 3679: 3673: 3672: 3643: 3637: 3636: 3607: 3598: 3597: 3587: 3563: 3554: 3553: 3548:Habif T (2016). 3545: 3532: 3531: 3511: 3502: 3501: 3483: 3459: 3450: 3449: 3429: 3423: 3422: 3383: 3377: 3376: 3358: 3334: 3328: 3327: 3309: 3285: 3279: 3278: 3269:(2 Suppl): 4–7. 3258: 3252: 3251: 3241: 3217: 3211: 3210: 3172: 3161: 3160: 3158: 3156: 3142: 3136: 3135: 3133: 3131: 3116: 3110: 3109: 3107: 3105: 3091: 3080: 3079: 3069: 3045: 3039: 3038: 3002: 2996: 2995: 2959: 2953: 2952: 2924: 2915: 2914: 2893: 2884: 2883: 2865: 2848: 2847: 2829: 2820: 2819: 2809: 2785: 2776: 2775: 2739: 2733: 2732: 2730: 2728: 2713: 2707: 2706: 2700: 2692: 2667: 2661: 2660: 2624: 2611: 2610: 2600: 2576: 2570: 2569: 2541: 2530: 2529: 2493: 2487: 2486: 2476: 2452: 2443: 2442: 2413: 2404: 2403: 2393: 2361: 2350: 2349: 2321: 2312: 2311: 2275: 2248: 2247: 2227: 2221: 2220: 2210: 2200: 2176: 2170: 2169: 2133: 2127: 2126: 2098: 2092: 2091: 2055: 2049: 2048: 2020: 2014: 2013: 2005: 1994: 1993: 1965: 1954: 1953: 1943: 1919: 1913: 1912: 1875: 1866: 1865: 1855: 1831: 1825: 1824: 1787: 1781: 1780: 1743: 1737: 1736: 1734: 1733: 1719: 1713: 1712: 1692: 1686: 1685: 1668:(1 Pt 2): 8–10. 1657: 1651: 1650: 1629: 1623: 1612: 1606: 1605: 1599: 1591: 1565: 1554: 1553: 1529: 1520: 1505: 1499: 1498: 1488: 1464: 1458: 1457: 1439: 1433: 1432: 1414: 1292:photosensitizing 1288:immunosuppressed 1047:Euphorbia peplus 1041:Ingenol mebutate 973: 972: 964: 961: 955: 953: 912: 881: 880: 873: 727:sun-damaged skin 679:subcutaneous fat 462:arachidonic acid 383:132, allows for 346:The presence of 246:, and scattered 152:is recommended. 119:light exposure ( 117:ultraviolet (UV) 96:senile keratosis 60: 40: 21: 7275: 7274: 7270: 7269: 7268: 7266: 7265: 7264: 7250: 7249: 7248: 7238: 7236: 7228: 7226: 7217: 7201: 7167: 7111:Epidermal nevus 7091: 7087:Periungual wart 7058: 7031:Keratoacanthoma 7025: 7001:Melanoacanthoma 6959: 6949: 6908: 6885: 6866:Bowen's disease 6817: 6718: 6709: 6679: 6674: 6621: 6569: 6560:Actinic prurigo 6500: 6484:Acne aestivalis 6464:Solar urticaria 6436: 6434:Photodermatoses 6430: 6400: 6391: 6323: 6316: 6283: 6249:Alopecia areata 6227: 6209: 6195: 6152: 6131: 6107: 6097: 6054: 6013: 5999:Viral exanthems 5977: 5961: 5959: 5949: 5920:Pityriasis alba 5898: 5840: 5782: 5719: 5639: 5635:Zinc deficiency 5565: 5563: 5544: 5472: 5463: 5427: 5418:Nevus sebaceous 5352: 5349: 5319: 5314: 5313: 5279: 5278: 5222: 5208: 5207: 5171: 5170: 5166: 5130: 5129: 5125: 5087: 5086: 5082: 5036: 5035: 5028: 4990: 4989: 4985: 4955: 4954: 4947: 4926:(1 Pt 2): 4–7. 4917: 4916: 4909: 4879: 4878: 4874: 4852: 4851: 4847: 4809: 4808: 4801: 4770:(11): 2523–30. 4757: 4756: 4749: 4720:(8589): 795–7. 4711: 4710: 4703: 4672: 4671: 4667: 4636: 4635: 4631: 4601: 4600: 4596: 4566: 4565: 4561: 4523: 4522: 4518: 4480: 4479: 4475: 4445: 4444: 4440: 4401: 4400: 4396: 4352: 4351: 4347: 4316: 4315: 4311: 4272: 4271: 4267: 4221: 4220: 4216: 4186: 4185: 4181: 4151: 4150: 4146: 4133:(12): 1118–24. 4124: 4123: 4119: 4089: 4088: 4077: 4067: 4065: 4060: 4059: 4055: 4045: 4043: 4032: 4028: 4027: 4023: 4013: 4011: 4000: 3996: 3995: 3991: 3981: 3979: 3967: 3966: 3962: 3923: 3922: 3918: 3888: 3887: 3883: 3839: 3838: 3834: 3796: 3795: 3788: 3758: 3757: 3753: 3709: 3708: 3704: 3694: 3692: 3685: 3681: 3680: 3676: 3645: 3644: 3640: 3609: 3608: 3601: 3565: 3564: 3557: 3547: 3546: 3535: 3513: 3512: 3505: 3461: 3460: 3453: 3431: 3430: 3426: 3385: 3384: 3380: 3336: 3335: 3331: 3287: 3286: 3282: 3260: 3259: 3255: 3219: 3218: 3214: 3174: 3173: 3164: 3154: 3152: 3144: 3143: 3139: 3129: 3127: 3118: 3117: 3113: 3103: 3101: 3093: 3092: 3083: 3047: 3046: 3042: 3004: 3003: 2999: 2961: 2960: 2956: 2926: 2925: 2918: 2911: 2895: 2894: 2887: 2880: 2867: 2866: 2851: 2844: 2831: 2830: 2823: 2787: 2786: 2779: 2741: 2740: 2736: 2726: 2724: 2715: 2714: 2710: 2693: 2681: 2669: 2668: 2664: 2626: 2625: 2614: 2591:(16): 1147–51. 2578: 2577: 2573: 2543: 2542: 2533: 2495: 2494: 2490: 2454: 2453: 2446: 2415: 2414: 2407: 2363: 2362: 2353: 2323: 2322: 2315: 2277: 2276: 2251: 2229: 2228: 2224: 2178: 2177: 2173: 2135: 2134: 2130: 2100: 2099: 2095: 2057: 2056: 2052: 2022: 2021: 2017: 2007: 2006: 1997: 1967: 1966: 1957: 1921: 1920: 1916: 1877: 1876: 1869: 1833: 1832: 1828: 1789: 1788: 1784: 1755:(11): 2069–79. 1745: 1744: 1740: 1731: 1729: 1721: 1720: 1716: 1694: 1693: 1689: 1659: 1658: 1654: 1647: 1631: 1630: 1626: 1613: 1609: 1592: 1580: 1567: 1566: 1557: 1531: 1530: 1523: 1506: 1502: 1479:(5): 691, 699. 1466: 1465: 1461: 1454: 1441: 1440: 1436: 1429: 1416: 1415: 1411: 1406: 1362: 1341: 1332: 1330:Clinical course 1300: 1273: 1251: 1244: 1236: 1224: 1207:stratum corneum 1181: 1141: 1125:Liquid nitrogen 1114: 1109: 1098: 1069: 1056: 1038: 1015: 1013:Imiquimod cream 995: 987: 974: 970: 965: 959: 956: 913: 902: 898:primary sources 882: 878: 871: 807: 783: 687: 655: 569: 530: 483: 428: 369: 336:Bowen's disease 323:lentigo maligna 271: 248:telangiectasias 211: 92:solar keratosis 38: 35: 28: 23: 22: 15: 12: 11: 5: 7273: 7271: 7263: 7262: 7252: 7251: 7247: 7246: 7223: 7222: 7219: 7218: 7216: 7215: 7213:Cutaneous horn 7209: 7207: 7203: 7202: 7200: 7199: 7194: 7189: 7184: 7178: 7176: 7169: 7168: 7166: 7165: 7160: 7155: 7150: 7145: 7140: 7135: 7134: 7133: 7128: 7123: 7114: 7112: 7105: 7101: 7100: 7097: 7096: 7093: 7092: 7090: 7089: 7084: 7079: 7074: 7068: 7066: 7060: 7059: 7057: 7056: 7051: 7046: 7041: 7035: 7033: 7027: 7026: 7024: 7023: 7018: 7013: 7008: 7003: 6998: 6997: 6996: 6991: 6986: 6981: 6972: 6970: 6961: 6955: 6954: 6951: 6950: 6948: 6947: 6942: 6937: 6932: 6927: 6922: 6916: 6914: 6910: 6909: 6907: 6906: 6901: 6895: 6893: 6891:Adenocarcinoma 6887: 6886: 6884: 6883: 6878: 6873: 6868: 6863: 6858: 6857: 6856: 6851: 6846: 6841: 6836: 6827: 6825: 6819: 6818: 6816: 6815: 6810: 6809: 6808: 6803: 6798: 6793: 6788: 6783: 6778: 6773: 6768: 6763: 6758: 6753: 6744: 6742: 6733: 6724: 6720: 6719: 6710: 6708: 6707: 6700: 6693: 6685: 6676: 6675: 6673: 6672: 6667: 6662: 6657: 6652: 6646: 6645: 6644: 6633: 6631: 6627: 6626: 6623: 6622: 6620: 6619: 6614: 6609: 6603: 6598: 6593: 6583: 6581: 6571: 6570: 6568: 6567: 6562: 6557: 6552: 6547: 6546: 6545: 6540: 6535: 6530: 6519: 6517: 6508: 6502: 6501: 6499: 6498: 6496:Solar erythema 6493: 6488: 6487: 6486: 6481: 6476: 6466: 6461: 6456: 6450: 6448: 6438: 6437: 6431: 6429: 6428: 6421: 6414: 6406: 6397: 6396: 6393: 6392: 6390: 6389: 6384: 6379: 6374: 6372:Coxsackievirus 6369: 6364: 6359: 6354: 6349: 6344: 6339: 6334: 6328: 6326: 6318: 6317: 6315: 6314: 6309: 6304: 6299: 6293: 6291: 6285: 6284: 6282: 6281: 6276: 6271: 6266: 6261: 6256: 6251: 6246: 6241: 6235: 6233: 6229: 6228: 6226: 6225: 6222: 6220: 6211: 6205: 6204: 6201: 6200: 6197: 6196: 6194: 6193: 6188: 6183: 6178: 6168: 6166: 6162: 6161: 6158: 6157: 6154: 6153: 6151: 6150: 6145: 6139: 6137: 6133: 6132: 6130: 6129: 6124: 6118: 6116: 6109: 6103: 6102: 6099: 6098: 6096: 6095: 6089: 6084: 6082:Gyratum repens 6079: 6074: 6068: 6062: 6060: 6056: 6055: 6053: 6052: 6047: 6042: 6037: 6032: 6027: 6021: 6019: 6015: 6014: 6012: 6011: 6006: 6004:Toxic erythema 6001: 5996: 5994:Drug eruptions 5990: 5988: 5981: 5970: 5963: 5955: 5954: 5951: 5950: 5948: 5947: 5942: 5937: 5932: 5927: 5922: 5917: 5912: 5906: 5904: 5900: 5899: 5897: 5896: 5891: 5886: 5881: 5876: 5871: 5866: 5861: 5856: 5850: 5848: 5842: 5841: 5839: 5838: 5833: 5831:Lichen nitidus 5828: 5823: 5818: 5813: 5808: 5803: 5798: 5792: 5790: 5784: 5783: 5781: 5780: 5775: 5770: 5765: 5760: 5755: 5750: 5745: 5740: 5735: 5733:Herpes simplex 5729: 5727: 5721: 5720: 5718: 5717: 5712: 5707: 5702: 5697: 5692: 5687: 5682: 5676: 5671: 5666: 5661: 5655: 5649: 5647: 5641: 5640: 5638: 5637: 5632: 5627: 5622: 5617: 5612: 5607: 5602: 5597: 5592: 5587: 5582: 5576: 5574: 5567: 5556: 5550: 5549: 5546: 5545: 5543: 5542: 5537: 5532: 5527: 5522: 5517: 5512: 5507: 5502: 5497: 5492: 5487: 5482: 5476: 5474: 5465: 5464: 5462: 5461: 5456: 5451: 5446: 5441: 5435: 5433: 5429: 5428: 5426: 5425: 5420: 5415: 5410: 5405: 5400: 5395: 5390: 5385: 5380: 5375: 5369: 5367: 5358: 5354: 5353: 5350: 5348: 5347: 5340: 5333: 5325: 5316: 5315: 5312: 5311: 5300: 5288: 5287: 5285: 5281: 5280: 5277: 5276: 5265: 5254: 5239: 5223: 5218: 5217: 5215: 5214:Classification 5206: 5205: 5164: 5143:(8): 1869–78. 5123: 5080: 5026: 4983: 4964:(6): 1045–52. 4945: 4907: 4872: 4845: 4799: 4747: 4701: 4665: 4629: 4594: 4559: 4516: 4473: 4438: 4403:extremities". 4394: 4345: 4326:(12): 1281–8. 4309: 4265: 4214: 4179: 4144: 4117: 4075: 4053: 4021: 3998:"NDA APPROVAL" 3989: 3960: 3916: 3881: 3852:(3): 560–578. 3832: 3786: 3751: 3722:(11): 1010–9. 3702: 3674: 3638: 3599: 3555: 3533: 3503: 3451: 3424: 3378: 3329: 3280: 3253: 3232:(4): 740–748. 3212: 3185:(5): 408–417. 3162: 3137: 3111: 3081: 3040: 2997: 2954: 2916: 2909: 2885: 2878: 2849: 2842: 2821: 2777: 2734: 2708: 2679: 2662: 2612: 2571: 2531: 2488: 2444: 2419:Cancer Letters 2405: 2351: 2313: 2286:(9): 895–904. 2249: 2222: 2171: 2128: 2093: 2050: 2015: 1995: 1955: 1914: 1867: 1826: 1782: 1738: 1714: 1703:(6): 599–606. 1687: 1652: 1645: 1624: 1607: 1578: 1555: 1521: 1500: 1459: 1452: 1434: 1427: 1408: 1407: 1405: 1402: 1361: 1358: 1340: 1337: 1331: 1328: 1327: 1326: 1323: 1320: 1299: 1296: 1271: 1250: 1249:Chemical peels 1247: 1242: 1234: 1231:carbon dioxide 1223: 1220: 1219: 1218: 1200: 1188: 1180: 1177: 1140: 1137: 1113: 1110: 1108: 1105: 1097: 1094: 1068: 1065: 1055: 1052: 1037: 1034: 1014: 1011: 994: 991: 986: 983: 976: 975: 968: 966: 885: 883: 876: 870: 867: 855: 854: 853: 852: 844: 841: 823: 822: 821: 818: 806: 803: 802: 801: 798: 782: 779: 778: 777: 774: 771: 767: 761: 758: 754: 715:orthokeratosis 686: 685:Histopathology 683: 654: 651: 568: 565: 564: 563: 559: 556:Bloom syndrome 544:Genodermatoses 541: 537: 529: 526: 525: 524: 518: 515: 512: 482: 479: 478: 477: 470: 427: 424: 381:chromosome 17p 368: 365: 344: 343: 332: 326: 315: 312:cutaneous horn 308: 305: 298: 270: 267: 210: 207: 192:5-fluorouracil 79: 78: 73: 67: 66: 62: 61: 53: 52: 49: 45: 44: 36: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 7272: 7261: 7258: 7257: 7255: 7245: 7235: 7231: 7214: 7211: 7210: 7208: 7204: 7198: 7195: 7193: 7190: 7188: 7185: 7183: 7180: 7179: 7177: 7175: 7170: 7164: 7161: 7159: 7156: 7154: 7151: 7149: 7146: 7144: 7141: 7139: 7136: 7132: 7129: 7127: 7124: 7122: 7119: 7118: 7116: 7115: 7113: 7109: 7106: 7102: 7088: 7085: 7083: 7080: 7078: 7077:Verruca plana 7075: 7073: 7070: 7069: 7067: 7065: 7061: 7055: 7052: 7050: 7047: 7045: 7042: 7040: 7037: 7036: 7034: 7032: 7028: 7022: 7019: 7017: 7014: 7012: 7011:Seboacanthoma 7009: 7007: 7004: 7002: 6999: 6995: 6994:Epidermolytic 6992: 6990: 6987: 6985: 6982: 6980: 6977: 6976: 6974: 6973: 6971: 6969: 6965: 6962: 6956: 6946: 6943: 6941: 6938: 6936: 6933: 6931: 6928: 6926: 6923: 6921: 6918: 6917: 6915: 6911: 6905: 6902: 6900: 6897: 6896: 6894: 6892: 6888: 6882: 6879: 6877: 6874: 6872: 6869: 6867: 6864: 6862: 6859: 6855: 6852: 6850: 6847: 6845: 6842: 6840: 6837: 6835: 6832: 6831: 6829: 6828: 6826: 6824: 6820: 6814: 6811: 6807: 6804: 6802: 6799: 6797: 6794: 6792: 6789: 6787: 6784: 6782: 6779: 6777: 6774: 6772: 6769: 6767: 6764: 6762: 6759: 6757: 6754: 6752: 6749: 6748: 6746: 6745: 6743: 6741: 6737: 6734: 6732: 6728: 6725: 6721: 6717: 6713: 6706: 6701: 6699: 6694: 6692: 6687: 6686: 6683: 6671: 6668: 6666: 6663: 6661: 6658: 6656: 6653: 6650: 6647: 6643: 6640: 6639: 6638: 6635: 6634: 6632: 6628: 6618: 6615: 6613: 6610: 6607: 6604: 6602: 6599: 6597: 6594: 6592: 6588: 6585: 6584: 6582: 6580: 6576: 6572: 6566: 6563: 6561: 6558: 6556: 6553: 6551: 6548: 6544: 6541: 6539: 6536: 6534: 6531: 6529: 6526: 6525: 6524: 6521: 6520: 6518: 6516: 6512: 6509: 6507: 6503: 6497: 6494: 6492: 6489: 6485: 6482: 6480: 6477: 6475: 6472: 6471: 6470: 6467: 6465: 6462: 6460: 6457: 6455: 6452: 6451: 6449: 6447: 6443: 6439: 6435: 6427: 6422: 6420: 6415: 6413: 6408: 6407: 6404: 6388: 6385: 6383: 6380: 6378: 6375: 6373: 6370: 6368: 6365: 6363: 6360: 6358: 6355: 6353: 6350: 6348: 6345: 6343: 6342:Lichen planus 6340: 6338: 6335: 6333: 6330: 6329: 6327: 6325: 6319: 6313: 6310: 6308: 6305: 6303: 6300: 6298: 6297:Onychomycosis 6295: 6294: 6292: 6290: 6286: 6280: 6277: 6275: 6272: 6270: 6267: 6265: 6262: 6260: 6259:Tinea capitis 6257: 6255: 6252: 6250: 6247: 6245: 6242: 6240: 6237: 6236: 6234: 6230: 6224: 6223: 6221: 6219: 6215: 6212: 6208:Miscellaneous 6206: 6192: 6189: 6187: 6184: 6182: 6179: 6177: 6173: 6170: 6169: 6167: 6163: 6149: 6146: 6144: 6141: 6140: 6138: 6134: 6128: 6125: 6123: 6120: 6119: 6117: 6113: 6110: 6106:Nonblanchable 6104: 6093: 6090: 6088: 6085: 6083: 6080: 6078: 6075: 6073: 6069: 6067: 6064: 6063: 6061: 6057: 6051: 6048: 6046: 6043: 6041: 6038: 6036: 6033: 6031: 6028: 6026: 6023: 6022: 6020: 6016: 6010: 6007: 6005: 6002: 6000: 5997: 5995: 5992: 5991: 5989: 5985: 5982: 5980: 5974: 5971: 5967: 5964: 5956: 5946: 5943: 5941: 5938: 5936: 5933: 5931: 5928: 5926: 5923: 5921: 5918: 5916: 5913: 5911: 5908: 5907: 5905: 5903:Hypopigmented 5901: 5895: 5892: 5890: 5887: 5885: 5882: 5880: 5877: 5875: 5872: 5870: 5867: 5865: 5862: 5860: 5857: 5855: 5854:Acne vulgaris 5852: 5851: 5849: 5847: 5843: 5837: 5834: 5832: 5829: 5827: 5824: 5822: 5819: 5817: 5814: 5812: 5809: 5807: 5806:Lichen planus 5804: 5802: 5799: 5797: 5794: 5793: 5791: 5789: 5785: 5779: 5776: 5774: 5771: 5769: 5766: 5764: 5761: 5759: 5756: 5754: 5751: 5749: 5746: 5744: 5741: 5739: 5738:Herpes zoster 5736: 5734: 5731: 5730: 5728: 5726: 5722: 5716: 5713: 5711: 5710:Parapsoriasis 5708: 5706: 5703: 5701: 5698: 5696: 5693: 5691: 5688: 5686: 5683: 5680: 5677: 5675: 5672: 5670: 5667: 5665: 5662: 5660: 5656: 5654: 5651: 5650: 5648: 5646: 5642: 5636: 5633: 5631: 5628: 5626: 5623: 5621: 5618: 5616: 5613: 5611: 5608: 5606: 5603: 5601: 5598: 5596: 5593: 5591: 5588: 5586: 5583: 5581: 5578: 5577: 5575: 5571: 5568: 5560: 5557: 5555: 5551: 5541: 5538: 5536: 5533: 5531: 5528: 5526: 5523: 5521: 5518: 5516: 5513: 5511: 5508: 5506: 5503: 5501: 5498: 5496: 5493: 5491: 5488: 5486: 5483: 5481: 5478: 5477: 5475: 5470: 5466: 5460: 5457: 5455: 5452: 5450: 5447: 5445: 5442: 5440: 5437: 5436: 5434: 5430: 5424: 5421: 5419: 5416: 5414: 5411: 5409: 5406: 5404: 5401: 5399: 5396: 5394: 5391: 5389: 5386: 5384: 5381: 5379: 5376: 5374: 5371: 5370: 5368: 5366: 5362: 5359: 5355: 5346: 5341: 5339: 5334: 5332: 5327: 5326: 5323: 5310: 5306: 5305: 5301: 5299: 5295: 5294: 5290: 5289: 5286: 5282: 5275: 5271: 5270: 5266: 5264: 5260: 5259: 5255: 5253: 5249: 5248: 5244: 5240: 5238: 5234: 5233: 5229: 5225: 5224: 5221: 5216: 5212: 5201: 5197: 5192: 5187: 5183: 5179: 5175: 5168: 5165: 5160: 5156: 5151: 5146: 5142: 5138: 5134: 5127: 5124: 5119: 5115: 5111: 5107: 5103: 5099: 5096:(1): 205–10. 5095: 5091: 5084: 5081: 5076: 5072: 5067: 5062: 5057: 5052: 5048: 5044: 5040: 5033: 5031: 5027: 5022: 5018: 5014: 5010: 5006: 5002: 4998: 4994: 4987: 4984: 4979: 4975: 4971: 4967: 4963: 4959: 4952: 4950: 4946: 4941: 4937: 4933: 4929: 4925: 4921: 4914: 4912: 4908: 4903: 4899: 4895: 4891: 4888:(4): 345–54. 4887: 4883: 4876: 4873: 4868: 4864: 4860: 4856: 4849: 4846: 4841: 4837: 4833: 4829: 4825: 4821: 4818:(3): 502–18. 4817: 4813: 4806: 4804: 4800: 4795: 4791: 4787: 4783: 4778: 4773: 4769: 4765: 4761: 4754: 4752: 4748: 4743: 4739: 4735: 4731: 4727: 4723: 4719: 4715: 4708: 4706: 4702: 4697: 4693: 4689: 4685: 4682:(2): 176–81. 4681: 4677: 4669: 4666: 4661: 4657: 4653: 4649: 4645: 4641: 4633: 4630: 4625: 4621: 4617: 4613: 4609: 4605: 4598: 4595: 4590: 4586: 4582: 4578: 4574: 4570: 4563: 4560: 4555: 4551: 4547: 4543: 4539: 4535: 4531: 4527: 4520: 4517: 4512: 4508: 4504: 4500: 4496: 4492: 4488: 4484: 4477: 4474: 4469: 4465: 4461: 4457: 4453: 4449: 4442: 4439: 4434: 4430: 4426: 4422: 4418: 4414: 4410: 4406: 4398: 4395: 4390: 4386: 4381: 4376: 4372: 4368: 4364: 4360: 4356: 4349: 4346: 4341: 4337: 4333: 4329: 4325: 4321: 4313: 4310: 4305: 4301: 4297: 4293: 4289: 4285: 4282:(2): 116–21. 4281: 4277: 4269: 4266: 4261: 4257: 4252: 4247: 4242: 4237: 4233: 4229: 4225: 4218: 4215: 4210: 4206: 4202: 4198: 4194: 4190: 4183: 4180: 4175: 4171: 4167: 4163: 4159: 4155: 4148: 4145: 4140: 4136: 4132: 4128: 4121: 4118: 4113: 4109: 4105: 4101: 4097: 4093: 4086: 4084: 4082: 4080: 4076: 4063: 4057: 4054: 4042: 4040: 4031: 4025: 4022: 4010: 4008: 3999: 3993: 3990: 3978: 3976: 3970: 3964: 3961: 3956: 3952: 3948: 3944: 3940: 3936: 3933:(1): 115–21. 3932: 3928: 3920: 3917: 3912: 3908: 3904: 3900: 3896: 3892: 3885: 3882: 3877: 3873: 3868: 3863: 3859: 3855: 3851: 3847: 3843: 3836: 3833: 3828: 3824: 3820: 3816: 3812: 3808: 3804: 3800: 3793: 3791: 3787: 3782: 3778: 3774: 3770: 3767:(6): 666–70. 3766: 3762: 3755: 3752: 3747: 3743: 3739: 3735: 3730: 3725: 3721: 3717: 3713: 3706: 3703: 3691: 3684: 3678: 3675: 3670: 3666: 3662: 3658: 3655:(3): 486–93. 3654: 3650: 3642: 3639: 3634: 3630: 3626: 3622: 3619:(4): 582–90. 3618: 3614: 3606: 3604: 3600: 3595: 3591: 3586: 3581: 3578:(6): 1251–5. 3577: 3573: 3569: 3562: 3560: 3556: 3551: 3544: 3542: 3540: 3538: 3534: 3529: 3525: 3521: 3517: 3510: 3508: 3504: 3499: 3495: 3491: 3487: 3482: 3477: 3473: 3469: 3465: 3458: 3456: 3452: 3447: 3443: 3439: 3435: 3428: 3425: 3420: 3416: 3412: 3408: 3404: 3400: 3397:(5): 209–14. 3396: 3392: 3391: 3382: 3379: 3374: 3370: 3366: 3362: 3357: 3352: 3349:(5): 453–63. 3348: 3344: 3340: 3333: 3330: 3325: 3321: 3317: 3313: 3308: 3303: 3299: 3295: 3291: 3284: 3281: 3276: 3272: 3268: 3264: 3257: 3254: 3249: 3245: 3240: 3235: 3231: 3227: 3223: 3216: 3213: 3208: 3204: 3200: 3196: 3192: 3188: 3184: 3180: 3179: 3171: 3169: 3167: 3163: 3151: 3147: 3141: 3138: 3126:. 14 Sep 2017 3125: 3121: 3115: 3112: 3100: 3096: 3090: 3088: 3086: 3082: 3077: 3073: 3068: 3063: 3059: 3055: 3051: 3044: 3041: 3036: 3032: 3028: 3024: 3020: 3016: 3013:(6): 1212–7. 3012: 3008: 3001: 2998: 2993: 2989: 2985: 2981: 2977: 2973: 2970:(11): 970–6. 2969: 2965: 2958: 2955: 2950: 2946: 2942: 2938: 2934: 2930: 2923: 2921: 2917: 2912: 2906: 2902: 2898: 2892: 2890: 2886: 2881: 2879:9780723435716 2875: 2871: 2864: 2862: 2860: 2858: 2856: 2854: 2850: 2845: 2839: 2835: 2828: 2826: 2822: 2817: 2813: 2808: 2803: 2800:(8): 1971–8. 2799: 2795: 2791: 2784: 2782: 2778: 2773: 2769: 2765: 2761: 2757: 2753: 2749: 2745: 2738: 2735: 2722: 2718: 2712: 2709: 2704: 2698: 2690: 2686: 2682: 2676: 2672: 2666: 2663: 2658: 2654: 2650: 2646: 2642: 2638: 2635:(6): 1033–9. 2634: 2630: 2623: 2621: 2619: 2617: 2613: 2608: 2604: 2599: 2594: 2590: 2586: 2582: 2575: 2572: 2567: 2563: 2559: 2555: 2551: 2547: 2540: 2538: 2536: 2532: 2527: 2523: 2519: 2515: 2511: 2507: 2503: 2499: 2492: 2489: 2484: 2480: 2475: 2470: 2466: 2462: 2458: 2451: 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1818: 1814: 1810: 1806: 1802: 1798: 1794: 1786: 1783: 1778: 1774: 1770: 1766: 1762: 1758: 1754: 1750: 1742: 1739: 1728: 1724: 1718: 1715: 1710: 1706: 1702: 1698: 1691: 1688: 1683: 1679: 1675: 1671: 1667: 1663: 1656: 1653: 1648: 1642: 1638: 1634: 1628: 1625: 1622: 1621: 1616: 1611: 1608: 1603: 1597: 1589: 1585: 1581: 1575: 1571: 1564: 1562: 1560: 1556: 1551: 1547: 1543: 1539: 1535: 1528: 1526: 1522: 1518: 1517:0-07-138076-0 1514: 1510: 1504: 1501: 1496: 1492: 1487: 1482: 1478: 1474: 1470: 1463: 1460: 1455: 1453:0-397-54589-4 1449: 1445: 1438: 1435: 1430: 1424: 1420: 1413: 1410: 1403: 1401: 1399: 1395: 1391: 1387: 1383: 1382:Afamelanotide 1377: 1375: 1371: 1367: 1359: 1357: 1353: 1349: 1347: 1338: 1336: 1329: 1324: 1321: 1317: 1316: 1315: 1313: 1304: 1297: 1295: 1294:medications. 1293: 1289: 1285: 1282:infection or 1281: 1275: 1269: 1268:glycolic acid 1265: 1261: 1256: 1255:chemical peel 1248: 1246: 1240: 1232: 1228: 1227:Laser therapy 1222:Laser therapy 1221: 1216: 1212: 1208: 1204: 1201: 1197: 1193: 1189: 1186: 1183: 1182: 1178: 1176: 1172: 1168: 1166: 1162: 1158: 1150: 1145: 1138: 1136: 1132: 1128: 1126: 1118: 1111: 1106: 1104: 1102: 1095: 1093: 1090: 1086: 1081: 1078: 1074: 1066: 1064: 1061: 1053: 1051: 1049: 1048: 1042: 1035: 1033: 1029: 1027: 1023: 1022:immune system 1019: 1012: 1010: 1008: 1004: 1000: 992: 990: 984: 982: 967: 963: 960:November 2017 952: 949: 945: 942: 938: 935: 931: 928: 924: 921: – 920: 916: 915:Find sources: 910: 906: 900: 899: 895: 891: 886:This section 884: 875: 874: 868: 866: 863: 861: 849: 845: 842: 839: 835: 831: 827: 826: 824: 819: 816: 815: 813: 812: 811: 804: 799: 796: 795: 794: 790: 787: 780: 775: 772: 768: 765: 764:Achantholytic 762: 759: 755: 752: 748: 747:parakeratosis 744: 743: 742: 738: 736: 732: 731:keratinocytes 728: 724: 720: 719:parakeratosis 716: 712: 708: 699: 691: 684: 682: 680: 676: 672: 668: 663: 660: 652: 650: 648: 644: 640: 636: 632: 628: 627:porokeratosis 624: 620: 616: 612: 608: 604: 600: 596: 592: 590: 586: 582: 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6506:Non-ionizing 6312:Ingrown nail 5884:Dermatophyte 5879:Gonococcemia 5864:Folliculitis 5505:Neurofibroma 5473:subcutaneous 5397: 5302: 5291: 5267: 5256: 5241: 5226: 5184:(6): 20–34. 5181: 5177: 5167: 5140: 5136: 5126: 5093: 5089: 5083: 5049:(4): 85–90. 5046: 5042: 4996: 4992: 4986: 4961: 4957: 4923: 4919: 4885: 4881: 4875: 4858: 4854: 4848: 4815: 4811: 4767: 4763: 4717: 4713: 4679: 4675: 4668: 4643: 4639: 4632: 4607: 4603: 4597: 4575:(6): 513–6. 4572: 4568: 4562: 4532:(2): 114–9. 4529: 4525: 4519: 4489:(1): 17–21. 4486: 4482: 4476: 4451: 4447: 4441: 4411:(5): 994–9. 4408: 4404: 4397: 4362: 4358: 4348: 4323: 4319: 4312: 4279: 4275: 4268: 4231: 4227: 4217: 4192: 4188: 4182: 4160:(5): 631–2. 4157: 4153: 4147: 4130: 4126: 4120: 4095: 4091: 4066:. 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5540:Myxoid cyst 5388:Acrochordon 5293:MedlinePlus 4999:(2): 62–6. 4646:(1): 95–8. 4454:(1): 43–7. 4068:15 December 3982:15 December 3155:13 December 3104:13 December 2870:Dermatology 2552:(1): 72–9. 2467:(1): 93–7. 2425:(1): 23–9. 1934:(1): 1–15. 1846:(7): 43–8. 1386:melanocytes 1112:Cryotherapy 1003:methylation 888:needs more 860:vaccination 757:structures. 707:basal layer 631:viral warts 585:skin cancer 502:odds ratios 472:History of 202:Cryotherapy 157:millimeters 76:Dermatology 48:Other names 7117:Syndromes 6989:Clear-cell 6979:Large-cell 6844:Clear-cell 6660:Photoaging 6307:Paronychia 6148:Vasculitis 6072:Multiforme 6070:Erythema ( 6025:Cellulitis 5976:Blanchable 5725:Blistering 5715:Ichthyosis 5573:Eczematous 5485:Hemangioma 5304:Patient UK 5269:DiseasesDB 4234:(1): 1–9. 3522:: 339–55. 2935:(6): 732. 1732:2019-11-25 1588:1055569130 1404:References 1346:phenotypic 1215:anesthetic 1107:Procedures 985:Medication 930:newspapers 869:Management 851:sunlight.” 805:Prevention 786:Dermoscopy 781:Dermoscopy 546:: Certain 393:neoplastic 385:cell cycle 352:nodularity 348:ulceration 240:ecchymoses 184:histologic 7206:Ungrouped 6984:Fissuring 6968:Acanthoma 6913:Ungrouped 6796:Pore-like 6786:Pigmented 6731:Carcinoma 6716:epidermis 6302:Psoriasis 6210:disorders 6165:Indurated 6066:Urticaria 6018:Localized 5960:epidermal 5743:Varicella 5653:Psoriasis 5564:epidermal 5530:Leiomyoma 5432:Pigmented 5365:Epidermal 5118:205257237 4794:205654597 3490:0007-0963 3324:207070300 3035:205260667 2697:cite book 2689:311871073 2308:221808877 1596:cite book 1398:cetuximab 1394:gefitinib 1298:Prognosis 1192:curettage 1163:(MAL) or 1089:acitretin 1085:tretinoin 1077:adapalene 1073:retinoids 1067:Retinoids 1026:cytokines 1018:Imiquimod 858:includes 711:epidermis 657:A lesion 643:psoriasis 611:cutaneous 567:Diagnosis 510:Freckling 452:thymidine 340:histology 255:oncogenic 234:texture, 196:imiquimod 161:sandpaper 110:epidermal 71:Specialty 7254:Category 7244:Medicine 7054:Solitary 7049:Multiple 6839:Basaloid 6791:Polypoid 6751:Aberrant 6575:Infrared 6446:ionizing 6377:Syphilis 6324:membrane 5979:Erythema 5915:Vitiligo 5869:Impetigo 5846:Pustular 5811:Miliaria 5659:Corporis 5510:Xanthoma 5459:Melanoma 5439:Freckles 5200:20725548 5159:16763547 5110:18476957 5075:24926428 5021:24283465 4940:10607349 4902:19470418 4867:12353680 4840:24851936 4832:23647091 4786:19382202 4742:10685710 4624:11599398 4589:10469105 4554:11048857 4546:15004822 4433:28246511 4425:18341663 4389:23235610 4340:25162181 4304:23405229 4296:18643849 4260:18728698 4139:23316984 4112:10607354 4046:30 March 4014:30 March 3955:27938071 3947:15659144 3911:12833014 3876:29331386 3827:20675689 3819:16235081 3781:23553119 3738:22417254 3695:30 March 3669:22055282 3633:20133013 3594:16557235 3528:12528411 3498:28098380 3446:12080275 3411:16502198 3373:13367783 3365:19416373 3316:23550994 3275:12353679 3248:30447074 3207:22467851 3199:28510496 3076:10607352 3027:21083845 2992:40465474 2984:17908179 2949:19528439 2899:(2010). 2897:Weedon D 2816:23510990 2772:34277084 2764:17638729 2657:21909024 2518:17488400 2483:15982308 2400:24627245 2300:17822489 2244:16935787 2217:29316678 2191:(1): 8. 2166:23353708 2158:19515076 2123:16310072 2088:73180732 2045:15814119 1990:23228302 1909:24067576 1901:15357755 1862:20729970 1821:10970924 1813:22329784 1777:19644716 1769:26370093 1709:17229598 1682:10607350 1635:(2010). 1633:Weedon D 1550:16935787 1495:18474700 1360:Research 1083:Topical 1071:Topical 1058:Topical 997:Topical 846:Wearing 647:melanoma 403:ligand, 356:bleeding 310:AK with 295:erythema 269:Variants 244:dry skin 180:excision 6834:Adenoid 6781:Nodular 6714:of the 6454:Sunburn 6176:morphea 6136:Papular 6115:Macular 6108:Purpura 6092:Ab igne 6077:Migrans 6030:Abscess 5958:Without 5940:Leprosy 5859:Rosacea 5796:Scabies 5788:Papular 5657:Tinea ( 5645:Scaling 5449:Melasma 5444:Lentigo 5357:Growths 5263:D055623 5191:2921754 5066:4053710 5013:2296232 4978:3204179 4734:2895318 4696:7857114 4660:7529779 4511:9346937 4503:8556252 4468:9922011 4380:6599879 4251:2503644 4209:7962774 4174:7142470 3925:skin". 3867:6652228 2727:26 June 2649:9990367 2607:8377777 2566:3257372 2526:1748119 2439:7923098 2391:4065271 2346:7930674 2208:5874665 2080:2039721 1950:2405022 1853:2924136 1486:2377206 1374:in vivo 1284:keloids 944:scholar 909:removed 709:of the 603:in situ 494:Melanin 474:sunburn 291:papules 287:macules 236:purpura 98:, is a 7230:Portal 7172:Other 6975:Forms 6960:tumors 6958:Benign 6830:Forms 6761:Cystic 6747:Forms 6322:Mucous 6218:Ulcers 5679:Faciei 5674:Manuum 5664:Cruris 5554:Rashes 5500:Lipoma 5495:Keloid 5469:Dermal 5378:Callus 5298:000827 5198: 5188: 5157: 5116: 5108: 5073: 5063: 5019: 5011: 4976: 4938: 4900: 4865: 4838: 4830: 4792: 4784: 4764:Cancer 4740: 4732: 4714:Lancet 4694: 4658: 4622: 4587: 4552: 4544: 4509: 4501: 4466: 4431: 4423: 4387: 4377: 4338: 4302: 4294: 4258: 4248: 4207: 4172: 4137: 4110: 3953: 3945: 3909: 3874: 3864: 3825: 3817: 3779: 3746:481891 3744: 3736: 3667: 3631: 3592: 3526: 3496: 3488: 3444: 3419:226134 3417: 3409: 3371: 3363: 3322: 3314: 3273: 3246: 3205: 3197: 3124:nhs.uk 3074: 3033: 3025: 2990: 2982: 2947: 2907: 2876: 2840: 2814: 2770: 2762: 2687: 2677: 2655: 2647: 2605: 2564: 2524: 2516: 2481: 2437: 2398: 2388: 2344: 2306: 2298: 2242: 2215: 2205: 2164: 2156: 2121: 2086: 2078: 2043: 1988: 1948: 1907: 1899: 1860: 1850: 1819: 1811: 1775: 1767: 1707: 1680: 1643: 1586: 1576: 1548: 1515: 1493: 1483: 1450: 1425: 1239:Er:YAG 1229:using 946: 939: 932: 925: 917: 671:dermis 659:biopsy 653:Biopsy 599:biopsy 581:biopsy 367:Causes 231:plaque 176:biopsy 122:actin- 7174:nevus 7104:Other 6723:Tumor 6642:Acute 6630:Other 5669:Pedis 5454:Nevus 5274:29438 5252:702.0 5237:L57.0 5114:S2CID 5017:S2CID 4855:Cutis 4836:S2CID 4790:S2CID 4738:S2CID 4550:S2CID 4507:S2CID 4429:S2CID 4300:S2CID 4041:(FDA) 4037:U.S. 4033:(PDF) 4009:(FDA) 4005:U.S. 4001:(PDF) 3977:(FDA) 3973:U.S. 3951:S2CID 3823:S2CID 3742:S2CID 3686:(PDF) 3415:S2CID 3369:S2CID 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