A precancerous skin lesion that is often misdiagnosed

Abstract

BACKGROUND: Disseminated superficial actinic porokeratosis (DSAP) is a precancerous skin condition often seen by dermatologists that is characterised by multiple annular hyperkeratotic lesions on sun-exposed areas. In Australia, DSAP is not a rare condition, possibly owing to Australia's high levels of sun exposure, and patients with DSAP often initially present to general practitioners (GPs). A lack of awareness about DSAP may result in misdiagnosis and inappropriate management of the condition. OBJECTIVE: The aim of this article is to provide an overview of DSAP relevant to GPs to better facilitate diagnosis, management and referral to a dermatologist. DISCUSSION: The underlying pathophysiological mechanism of DSAP is unknown. Although there is currently no effective standardised treatment, ongoing management is warranted, given the potential for malignant transformation. Suggested strategies include frequent full skin checks, patient education about sun protection and ablative treatment (such as cryotherapy) if indicated. Suspicious lesions require excision and histopathology.