Update on diagnosis and treatment of actinic keratosis

Actinic keratosis (AK) is a relatively common skin condition occurring due to chronic sun-exposure, primarily affecting fair skin. Most dermatologists consider it an incipient malignancy due to its risk of full-blown malignant transformation to squamous cell carcinoma. However, the exact risk factors remain unknown, and thus its course cannot be predicted. Therefore, all cases of AK need early diagnosis and appropriate treatment to mitigate this risk. Over the years, several noninvasive diagnostic techniques such as dermoscopy, reflectance confocal microscopy, and newer treatment modalities (lesion-directed and field-directed) have been introduced with their own set of advantages and disadvantages. Notably, invasive skin biopsy with histopathology remains the gold-standard for diagnosis. Prevention is of paramount importance, highlighted by adequate sun-protection measures. This article reviews the diagnostic and treatment modalities of AK, with their latest updates, to optimize patient management.