MCQ – 71921

Correct Answer � B Explanation

Ans:B.)May progress to Basal Cell Carcinoma

The patient in question is suffering from Actinic Keratosis.

ACTINIC KERATOSIS

• lt is a UV light-induced lesion of the skin that may progress to invasive squamous cell carcinoma.
• Most common lesion with malignant potential to arise on the skin.
• Actinic keratosis arise on fair-skinned people in areas of long-term sun exposure, such as the face, ears, bald scalp, forearms, and backs of the hands.
• They may occur on any area that is repeatedly exposed to the sun, such as the back, the chest, and the legs.
• Long term UV light exposure is implicated as the cause from both epidemiologic observations and molecular analysis of tumor cells.
• Clinically, actinic keratosis range from barely perceptible rough spots of skin to elevated, hyperkeratotic plaques several centimeters in diameter.
• Most often, they appear as multiple discrete, flat or elevated, keratotic lesions.
• Lesions typically have an erythematous base covered by scale (hyperkeratosis).
• They are usually 3-10 mm in diameter and gradually enlarge into broader, more elevated lesions.
• Over time, actinic keratosis may develop into invasive squamous cells.
• A skin biopsy is indicated to confirm the diagnosis and to rule out invasive squamous cell carcinoma:
• Actinic keratosis is characterized by dysplasia and architectural disorder of the epidermis, as follows  :
  • Abnormal keratinocytes of the basal layer that are variable in size and shape
  • Altered cellular polarity
  • Nuclear atypia
  • Hyperkeratosis and parakeratosis of the epidermis
  • Irregular acanthosis may be present