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Difference Between Actinic Keratosis and Psoriasis

Actinic keratosis is when precancerous red patches of skin develop, which are rough to the touch. Psoriasis is when red and scaly skin patches develop due to some type of inflammatory response.

What is Actinic  keratosis?

Definition:

Actinic keratosis is when there is a change in the keratinocyte skin cells found in the outermost layer of the skin causing precancerous lesions and patches to form.

Causes and prevalence:

Sun exposure and using tanning beds can damage the skin in such a way as to result in actinic keratosis developing. The condition is also most prevalent in people who have fair skin than in people who have darker skin.

Symptoms and complications:

People with the condition first notice the development of sections of skin that are less than 2.5 cm in size and that become scaly and feel rough to the touch.  The rough pieces of skin develop on the body where skin is exposed, so on the face, arms and legs. The biggest danger with actinic keratosis is that it is a precursor to skin cancer in many cases, and, therefore, should be treated as quickly as possible.

Diagnosis:

Diagnosis can be confirmed after a doctor has cut out the piece of skin that is affected, and examined it under the microscope.

Treatment:

Sun avoidance is an important preventative step in protecting the skin. Sunscreen and sunblock are also useful inpreventing damage to the skin caused by the UV radiation of the sun. Skin creams containing tretinoin and surgical removal of skin lesions can also be done, particularly if skin cancer is a concern.

What is Psoriasis?

Definition:

Psoriasis is an inflammatory condition in which the skin becomes scaly and red in certain parts of the body.

Causes and prevalence:

The exact cause of psoriasis seems to vary but it is linked to an inflammatory immune system response involving T lymphocytes. There are also certain triggers for the condition such as sunburn, having HIV infection, feeling stressed, drinking alcohol, taking certain medications, and being very overweight. Psoriasis occurs in about 3% of the global population.

Symptoms and complications:

Symptoms of psoriasis include having scaly well-defined skin patches that are reddish in color and become itchy and scaly in appearance. These areas of skin occur most often on the head and backs of the knees and elbows. The red patches sometimes are raised and they can occur elsewhere on the body including the buttocks region and genitals. In some people the disease also causes arthritic pain in the joints; this is known as psoriatic arthritis.

Diagnosis:

A physical examination and examination of the lesions is used to diagnose psoriasis. Dermatologists may need to rule out other skin conditions as a way to confirm a diagnosis of psoriasis.  People with joint pain and skin lesions may be diagnosed with psoriatic arthritis, particularly if the joint problems only started after lesions developed.

Treatment:

Treatment can include the use of corticosteroid ointments, creams with salicylic acid, and vitamin D creams. Exact treatment options will vary depending on the patient and the degree of severity of the psoriasis. Sometimes oral medication such as methotrexate is prescribed to help in severe cases.

Difference between Actinic keratosis and Psoriasis?

Definition

Actinic keratosis is when skin lesions form that are scaly and rough and result from changes in keratinocytes. Psoriasis is when scaly, red patches of skin form due to an inflammatory response.

Lesions

The patches or lesions of actinic keratosis are very rough in appearance and reddish in color. The patches of skin, in the case of psoriasis, are red in color and scaly.

Precancerous 

Actinic keratosis is a skin problem that can develop into squamous cell carcinoma and is thus a precancerous condition. Psoriasis is a skin problem that does not lead to skin cancer, and therefore is not a precancerous condition.

Arthritis

Arthritis is not associated with actinic keratosis. Arthritis can sometimes be associated with psoriasis.

Complications

Actinic keratosis is a skin condition that can lead to squamous cell carcinoma, a type of cancer. Psoriasis can lead to arthritis in some cases and it increases the odds of developing a secondary infection.

Treatment

The condition of actinic keratosis can be treated using skin creams containing tretinoin and surgical removal of affected areas of skin. The condition of psoriasis can be treated using corticosteroid ointments, creams that contain the anti-inflammatory substance salicylic acid, and by using vitamin D creams.

Table comparing Actinic keratosis and Psoriasis

Summary of Actinic keratosis Vs. Psoriasis

  • Actinic keratosis and psoriasis both are skin afflictions, but the keratosis is the only condition that can become cancer.
  • Actinic keratosis is caused by exposure to UV radiation from tanning beds and sun exposure.
  • Psoriasis is due to inflammation of the skin, which could be a result of a number of factors, including sometimes, a bad sunburn.
  • Actinic keratosis and psoriasis both result in skin patches developing that can be unsightly.

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References :


[0]Benedetti, Julia. “Overview of effects of sunlight”. Merckmanuals. Merck & Co., 2019,https://www.msdmanuals.com/professional/dermatologic-disorders/reactions-to-sunlight/overview-of-effects-of-sunlight

[1]Das, Shinjita. “Psoriasis”. Merckmanuals. Merck & Co., 2020, https://www.merckmanuals.com/professional/dermatologic-disorders/psoriasis-and-scaling-diseases/psoriasis /

[2]Wells, Gregory L. “Squamous Cell Carcinoma”. Merckmanuals. Merck & Co., 2020, https://www.merckmanuals.com/professional/dermatologic-disorders/cancers-of-the-skin/squamous-cell-carcinoma

[3]Image credit: https://commons.wikimedia.org/wiki/File:SolarAcanthosis.jpg

[4]Image credit: https://pixabay.com/photos/psoriasis-skin-disease-red-scaly-356429/

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