Actinic Keratosis
The acronym “SPAIN” corresponds to the histological criteria:
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Actinic Keratosis
The acronym “SPAIN” corresponds to the histological criteria: Solar elastosis Parakeratosis Atypical basal layer keratinocytes Inflammatory infiltrate No full thickness keratinocyte atypia (if there is full thickness keratinocytic atypia consider squamous cell carcinoma in situ)
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SPAK (Spreading pigmented AK): • Also uses SPAIN mnemonic • However, there is no parakeratosis – Instead “P” in SPAK = pigmentation of basal layer keratinocytes • The clinical differential diagnosis includes lentigo or lentigo maligna
K.S. Masterpol et al., Atlas of Essential Dermatopathology, DOI 10.1007/978-1-4471-4471-7_24, © Springer-Verlag London 2013
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Actinic Keratosis
Fig. 24.1 Actinic keratosis. There is marked parakeratosis, keratinocytic atypia, inflammation and solar elastosis
Fig. 24.2 Spreading pigmented actinic keratosis. Basal layer keratinocytic hyperpigmentation is present with keratinocytic atypia and solar elastosis
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