An actinic keratosis is a scaling eruption that occurs most often in the sun exposed areas. This includes the scalp, ears, face, back of the hands and the forearms. These lesions are premalignant and if left untreated for months or years many change into squamous cell cancers.
This 82-year-old man complained of several isolated scaling lesions on the scalp. The doctor made a clinical diagnosis of actinic keratoses. The lesion on the anterior part of the scalp was thick and therefore the doctor performed a biopsy to be sure that the lesion was not a squamous cell cancer.
Each lesion was sprayed with liquid nitrogen. The thick lesion in the front of the scalp was biopsied and determined to be a squamous cell cancer. The patient therefore was referred to general surgeon for excision of this lesion.
The patient was asked to return for a followup examination in 6 months.