The future of keratinocyte skin cancer surveillance: automated image analysis to identify and monitor keratinocyte dysplasia.

Clinical assessment of actinic keratosis is known to be a variable process; however, there are currently no non-invasive alternatives for objectively assessing the condition besides excision and histopathology. While a number of technologies for examining potential actinic keratoses are under development, each of these still requires subjective human assessment. The existing approaches focus on assessing colour and texture features in clinical-scale images, such as those from dermoscopy and digital photography, and on structural or cellular characteristics in cellular-scale images, such as those from multiphoton microscopy and reflectance confocal microscopy. The future of actinic keratosis management is likely to be a combination of analysing regional photography to determine potential lesion locations and analysis of the structural and cellular features by reflectance confocal microscopy for an in vivo pathology diagnosis.