Certain genetic disorders result in increased sun sensitivity or decreased ability to repair cell damage. These individuals have a greater propensity for developing premalignancies and malignancies of the skin. The lesions are usually pink or skin colored and typically have a dry, overlying scale. Occasionally, the scale can be quite thick and appear as a hornlike projection. They are very rough and are often better detected by touch than by sight.
Some lesions can become tender or sensitive.
Actinic keratosis on the lower lip presents as diffuse chapping that does not resolve, despite liberal use of petroleum jelly or lip balms. When a lesion appears to be thickening into deeper layers of the skin, or when an ulcer develops, the possibility of malignant changes exists. When the possibility of cancer exists, a skin biopsy is obtained. The specimen is examined under a microscope to evaluate the damaged cells. If the cancerous cells fill the entire content of the epidermis, or if they extend beyond it, squamous cell carcinoma may be diagnosed.