Lesions may appear as horn-like protrusions

Introduction Skin lesions can be one of the main symptoms of actinic keratosis. The process of keratin formation in the horn is called keratinization. It is a process of converting cytoplasmic proteins into keratin proteins with completely different physical and chemical properties. The keratinization process includes fibrillation of the cytosol and decomposition and disappearance of the cytoplasm and nucleus.

Cause

Sunlight, ultraviolet light, radioactive heat, as well as bitumen or coal and its extracts can induce the disease, and the patient's susceptibility plays a decisive role.

an examination

Related inspection

Tissue plasminogen activator (t-PA)

According to clinical manifestations, it is generally not difficult to diagnose. The diagnosis must be pathologically examined.

Clinical manifestation

1. Susceptible and predilection sites: lesions are more common in middle-aged men exposed to sunlight, such as the face, auricle, back of the hand. In male patients, skin lesions can occur in the bald area, auricle and lower lip, and women are more common in the forearm extension.

2. Clinical symptoms: The lesions are brown-red or yellow spots or plaques with a clear boundary, ranging from a needle tip to a diameter of 2 cm or more, most of which are indefinitely several millimeters. Can be slightly higher than the leather surface, but no significant high edge. The surface is rough and keratotic scales are visible. Forcibly remove the scales, showing that the base surface below is ruddy, uneven, and papillary. Sometimes the skin lesions can be horny, and the formation of the skin lesions develops slowly and has no symptoms. There may be telangiectasia around the lesion.

complication

20% can be secondary to squamous cell carcinoma. When the lesion is combined with inflammation, erosion and ulceration, it is a sign of secondary squamous cell carcinoma.

Diagnosis: According to clinical manifestations, it is generally not difficult to diagnose. The diagnosis must be pathologically examined.

Differential diagnosis

1. Shrinkage on the surface of the skin lesions under cold stimulation: single or clustered painful papules or nodules appear in the clinic, and skin leiomyomatosis should be considered when the surface of the skin lesions shrinks under cold stimulation. Leiomyoma cutis is a benign tumor composed of skin fascia, mesothelial or vascular smooth muscle. There are few skin smooth muscles, mainly found in the hairy muscles near the hair follicles, the muscle fibers around the deep subcutaneous blood vessels, the smooth muscle bundles in the scrotum and the labia.

2. Plague-like lesions: Plague-like lesions are manifestations of clinical signs of Alcaligenes bacilli. Alcaligenetic bacillus pneumonia is a relatively rare bacterial-induced pneumonia.

3. Seborrheic keratosis: the surface has oily scales, the soft surface is smooth and the hard cuticle is not hard. The pathological histology shows the formation of epidermal cyst in the epidermis.

4. Discoid lupus erythematosus: there are dilated follicular pores and follicular horn plugs, and there is atrophy, skin lesions are good for facial expression, especially on the cheeks and nose, which is butterfly-like.

5. Malignant freckle-like sputum: occurs in the exposed part, is a pigment spot, can not be enlarged beyond the leather surface, the diameter can reach several centimeters, about 1/3 of the brown or black disease can be developed into malignant Melanoma. 4. Should also pay attention to the identification of linear epidermal squamous cell carcinoma, squamous cell carcinoma.

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