This study is carried out by Professor H. Peter Soyer (UQ DCR) in collaboration with Dr Rachel Neale (QIMR), Associate Professor Stephen Gilmore (UQ DRC), Associate Professor Nick Saunders (UQ DI) in collaboration with Dr Duncan Lambie (PAH Department of Pathology).

The aim of the study is to determine the feasibility of using Fotofinder and Reflectance Confocal Microscopy (RCM) to document natural history of actinic keratosis (AK) lesions. To accomplish this we will

• identify RCM characteristics that predict progression from AK to squamous cell carcinoma (SCC),
• determine the correlation between degree of photodamage to skin and incidence of AK's to SCC,
• determine whether genetic, immunological and environmental factors influence the incidence and/or natural history of AKs and
• determine the feasibility for larger prospective longitudinal cohort study.

The study comprises of sixty participants recruited from the dermatology and renal outpatients. Participation involves a questionnaire, RCM images on two AK evident lesions, whole body imaging, two silicone impressions on the hands and biopsy of suspicious lesions (if necessary and participant consent obtained). Final visit takes place in three month period after the initial visit and involves follow-up images, RCM and silicone impressions on the same sites as previously obtained.