Precancerous Lesions Actinic Keratosis and Dysplastic Nevus

Skin Cancer
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Amy Forman Taub, MD, FAAD

There are several skin conditions that can be a “precancer” or an indicator that one may be prone to skin cancers. Two of the most common are known as actinic keratosis and dysplastic nevus.

An actinic keratosis also known as an AK is usually a red or flesh colored scaly patch or bump that arises on the skins surface. Actinic keratosis can be the first step in the development of skin cancer. It is estimated that 10 to 15 percent of active lesions, which may be thicker, redder or more tender than the rest will take the next step and progress to a squamous cell carcinoma. Fortunately, these cancers are usually not life threatening, provided they are detected and treated in the early stages. However, if not discovered in a timely fashion, they can bleed, ulcerate, become infected, or grow large and invade the surrounding tissues, eventually spreading to the internal organs.

Dysplastic or atypical nevus (mole) can be flat or raised, and range in color from pink to black. They are concerning as melanomas may arise in them and they can be an indicator that one is more prone to getting melanoma.

Common ways to remember changes that are seen in melanoma are the ABCDE’s of melanoma.

  • Asymmetrical lesion
  • Border of the lesion is irregular
  • Color: there is multiple colors or changing colors
  • Diameter: moles greater than 6mm are concerning (but some less than this are also)
  • Evolution: evolving moles or changing moles are more likely to be atypical

Many moles, asymmetry or change in a mole or just a mole that looks different from your other moles should prompt you to come in to get a body check. The National Institute for Health says you should get a body check at least every 3 years even if you don’t have any risk factors.