Actinic keratosis

Actinic keratoses are sun-induced in situ epidermal tumors characterized by the proliferation of abnormal keratinocytes. Clinical lesions present as erythematous, rough, scaly, hyperkeratotic papules or plaques on sun exposed areas. However, a subclinical component may be present due to invasion of tumor cells down the hair follicle, sweat duct, or at the base of the epidermis without affecting keratinization and causing clinical change. Lesions with an increased risk of progression to invasive squamous cell carcinoma should be biopsied. The two main treatment approaches for actinic keratoses are field-directed and lesion-directed therapy. Cryotherapy is the most common form of treatment of actinic keratoses. Here, we present the technique, application, adverse events, efficacy, limitations, and compare cryotherapy versus other treatment modalities. Overall, cryotherapy coupled with field-directed therapy provides the best clinical outcome for the treatment of AKs.