Threshold Criteria
Actinic keratosis (AK) is a common sun induced scaly or hyperkeratotic lesion which has the potential to become malignant. NICE estimates that over 23% of the UK population aged over 60 years have AK.
The risk of AK turning in to a squamous cell carcinoma is very low, the risk increases over time and the more lesions the person has. The presence of 10 AK lesions is associated with a 14% risk of developing a squamous cell carcinoma within 5 year
Recent growth, pain, tenderness, bleeding or ulceration are suggestive of transformation in to a squamous cell carcinoma and should be regarded as a red flag.
Eligibility
| LLR ICB will only fund secondary care referral when the following criteria is met · Concern of squamous cell refer via 2WW dermatology pathway · Failure to respond to treatment in primary care · Immunosuppressed patient, in particular post-transplant patients No specific treatment is required for superficial, isolated lesions, which are not causing any discomfort. Patients should be given advice about sun avoidance and protection, as well as the signs of skin cancer formation. If there is diagnostic uncertainty advice can be sort via Advice and Guidance on ERS |
Guidance
| ARP4. Review Date: 2026 |
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