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An Actinic Keratosis (AK) is a common sun-induced scaly or hyperkeratotic lesion, which has the potential to become malignant. NICE estimates that over 23% of the UK population aged 60 and above have AK. Although the risk of an AK transforming into a squamous cell carcinoma (SCC) is very low, this risk increases over time, in the immunocompromised, those with previous SCCs and with larger numbers of lesions. The presence of ten AK is associated with a 14% risk of developing an SCC within five years.
The vast majority of AKs can be managed in primary care. To properly manage AKs, it is best to separate field change from separate lesions and stratify into mild, moderate and severe cases.
The majority of patients can be managed in primary care. Please see British Association of Dermatologists Referral Guideline
Consider referral to accredited GPwSI or secondary care
Lesions that are
Red flag signs that should prompt referral to secondary care are:
The majority of patients can be managed in primary care. Please see British Association of Dermatologists Referral Guideline
Consider referral to accredited GPwSI or secondary care
Lesions that are
For more information on actinic keratosis refer to:
The Primary Care Dermatology Society
South and West Devon formulary guidance - Skin
This guidance has been signed off by NHS Devon
Publication date: January 2017
Updated: June 2023