Background: Actinic keratoses are very common. They are usually benign, but may occasionally progress to invasive skin cancer. Thus it has been discussed whether actinic keratoses should be considered precancerous or as cancer. The way clinicians view these highly common lesions might affect the way they are treated.
Objective: Review the epidemiology, histopathology, pathology and treatment of actinic keratoses and squamous cell carcinoma - and compare the two conditions.
Methods: A review of the literature was done.
Results: Actinic keratoses occure commonly in the sun-exposed caucasian skin. Most important risk factors are fair skin phenotype and cumulative sun exposure. The prevalence increases with age. The same risk factors apply to squamous cell carsinoma. Histopathologically actinic keratoses and squamous cell carcinoma also show many similarities. They can be considered as the same disease process at different stages of evolution. There are many treatment modalities of actinic keratoses, less so for squamous cell carsinoma.
Conclusion: The litterature does not give an exact answer as to whether actinic keratoses should be considered as an early squamous cell carcinoma. Because of the many similarities it can be impossible to clinically distinguish between the two conditions. However actinic keratoses are a good marker for persons predisposed to the development of squamous cell carcinoma.