An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis - A Narrative Review

Sep 21, 2026

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Nonmelanocytic skin cancers represent the most common human cancers and include tumors that are not melanomas. Rising diagnosis is linked to increased sunlight exposure, insufficient sunscreen use, population aging, and improved screening methods. Squamous cell carcinoma accounts for nearly 37% and may originate from actinic keratosis, commonly appearing as pink scaly plaques on face or scalp. Advances in dermatoscopy and non-invasive imaging modalities such as HFUS, RCM, and OCT improve diagnostic sensitivity and enable better monitoring and qualification of challenging lesions where cosmetic outcomes matter.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

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Abstract

Introduction

Introduction to NMSC

Demographics and Clinical Presentation of AKs

Pathogenesis of AK

medicina Review An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis—A Narrative Review Katarzyna Korecka 1, *, Dominika Kwiatkowska 2, Ewelina Mazur 2,3, Aleksandra Da ´nczak-Pazdrowska 1, Adam Reich 2, Ryszard Z˙aba 1 and Adriana Pola ´nska 1 Citation: Korecka, K.; Kwiatkowska, D.; Mazur, E.; Da ´nczak-Pazdrowska, A.; Reich, A.; Z˙ aba, R.; Pola ´nska, A. An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis—A Narrative Review. Medicina 2024, 60, 1043. [https://](https://)[ ](https://)[doi.org/10.3390/medicina60071043](doi.org/10.3390/medicina60071043) Academic Editor: Paola Savoia Received: 3 June 2024 Revised: 17 June 2024 Accepted: 24 June 2024 Published: 26 June 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Dermatology, Pozna ´n University of Medical Sciences, 61-545 Pozna ´n, Poland; [aleksandra.danczak-pazdrowska@ump.edu.pl](aleksandra.danczak-pazdrowska@ump.edu.pl) (A.D.-P.); [apolanska@ump.edu.pl](apolanska@ump.edu.pl) (A.P.) 2 Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland 3 Doctoral School, University of Rzeszow, 35-310 Rzeszow, Poland * Correspondence: [kkorecka@ump.edu.pl](kkorecka@ump.edu.pl) Abstract: Nonmelanocytic skin cancers (NMSCs) are currently the most common group of human cancers and include all tumors that are not melanomas. Increased exposure to sunlight over the past few years, the lack of regular and proper use of sunscreen, the aging of the population, and better screening techniques are the reasons for the escalation in their diagnosis. Squamous cell carcinoma (SCC) comprises nearly 37% of the tumors in this group and can originate from actinic keratosis (AK), which usually presents as pink, often scaly plaques, usually located on the face or scalp. Advances in dermatoscopy, as well as the development of other non-invasive skin imaging modalities such as high-frequency ultrasound (HFUS), reflectance confocal microscopy (RCM), and optical coherence tomography (OCT), have allowed for greatly increased sensitivity in diagnosing these lesions and monitoring their treatment. Since AK therapy is usually local, and SCCs must be removed surgically, non-invasive imaging methods enable to correctly qualify difficult lesions. This is especially important given that they are very often located on the face, and achieving an appropriate cosmetic result after treatments in this area is very important for the patients. In this review, the authors describe the use of non-invasive skin imaging methods in the diagnosis of actinic keratosis. Keywords: actinic keratosis; noninvasive skin imaging; dermoscopy; high-frequency ultrasonography; reflectance confocal microscopy 1. Introduction 1.1. Introduction to NMSC Nonmelanocytic skin cancers (NMSCs) are currently the most common group of human cancers and include all tumors that are not melanomas. Since most of them occur in Caucasian patients, they are also called “white skin cancer” [1] . The increase in their diagnosis is associated with a longer life expectancy in the population, and they have a genetic background or are related to immunosuppression. However, the most significant cause of their occurrence is ultraviolet (UV) exposure [2] . The most common neoplasm in this group is basal cell carcinoma (BCC), which comprises about 63% of these tumors [3] . Squamous cell carcinomas (SCC) represent about 37% of diagnosed NMSC and can arise in areas of actinic keratosis (AK) or de novo [3] . Depending on a study, 60–80% of SCCs might develop on the basis of AK [4] . 1.2. Demographics and Clinica

FAQs

Why are nonmelanocytic skin cancers becoming more frequently diagnosed?

They are increasing due to greater sun exposure, inadequate regular sunscreen use, an aging population, and improved screening techniques.

How does actinic keratosis typically present clinically?

Actinic keratosis usually appears as pink, often scaly plaques located on the face or scalp, and it is commonly seen in older patients with fair skin phototypes and visible photodamage.

Which non-invasive imaging techniques are discussed for actinic keratosis?

The review highlights dermatoscopy and other non-invasive modalities including high-frequency ultrasound (HFUS), reflectance confocal microscopy (RCM), and optical coherence tomography (OCT).

Sep 21, 2026

Upload by Liam