Actinic keratosis typically presents as which description?

• A. Flesh-colored, pink or yellow-brown patches with erythema
• B. Rough, sandpaper feel lesions
• C. Velvety, stuck-on plaques
• D. Dome-shaped nodules with a keratin plug

Answer: (B)

Actinic keratosis is a sun-induced premalignant lesion of keratinocytes, and the hallmark clinical clue is a rough, sandpaper-like surface on sun-exposed skin. This gritty texture comes from hyperkeratosis and atypical keratinocyte changes caused by chronic UV damage, and these lesions are often scaly or crusted as well. That distinctive tactile experience—rough and sandpaper-like—is what makes this description the best match.

The other descriptions fit different conditions: a patch that is flesh-colored with erythema can be seen in various eczema or inflammatory patches; velvety, stuck-on plaques are characteristic of seborrheic keratosis; and a dome-shaped nodule with a keratin plug points to a keratoacanthoma.