AK with cutaneous horn: A cutaneous horn is a keratinic projection with its height at least one-half of its diameter, often conical in shape. They can be seen in the setting of actinic keratosis as a progression of an HAK, but are also present in other skin conditions. 38–40% of cutaneous horns represent AKs. Pigmented AK: Pigmented AKs are rare variants that often present as macules or plaques that are tan to brown in color. They can be difficult to distinguish from a solar lentigo or lentigo maligna. Actinic cheilitis: When an AK forms on the lip, it is called actinic cheilitis. This usually presents as a rough, scaly patch on the lip, often accompanied by the sensation of dry mouth and symptomatic splitting of the lips. Bowenoid AK: Usually presents as a solitary, erythematous, scaly patch or plaque with well-defined borders. Bowenoid AKs are differentiated from Bowens disease by degree of epithelial involvement as seen on histology.The presence of ulceration, nodularity, or bleeding should raise concern for malignancy. Specifically, clinical findings suggesting an increased risk of progression to squamous cell carcinoma can be recognized as "IDRBEU": I (induration/inflammation), D (diameter > 1 cm), R (rapid enlargement), B (bleeding), E (erythema), and U (ulceration). AKs are usually diagnosed clinically, but because they are difficult to clinically differentiate from squamous cell carcinoma, any concerning features warrant biopsy for diagnostic confirmation. Causes
The most important cause of AK formation is solar radiation, through a variety of mechanisms.
This altitude is known as Armstrongs Line. In practice bodily fluids do not boil off at this altitude. This is because the skin and outer organs have enough strength to withstand this pressure, thus pressure inside the body would be significantly higher—however, nitrogen bubbles are starting to form, creating a hazard. Prevention
To prevent ebullism, a pure oxygen (O2) atmosphere was used in early space flights to eliminate nitrogen in the blood. There are major fire hazards associated with using pure O2 as a breathing gas, which was central to the death of three astronauts in a fire during a ground test with Apollo 1. Nonetheless, NASA continued to use a nominally pure oxygen atmosphere throughout the Apollo Program but switched to air for the follow-on Space Transport System "Space Shuttle". Russian cosmonauts used pure oxygen before changing to a higher-pressure nitrox mixture, leading to incompatibility problems in 1975 on the Apollo-Soyuz Test Project. Space suits are often pressurized to several psi lower than stations capsules or shuttles and since they still use pure O2, an acclimation period is common in the airlock to remove nitrogen and other gases from the bloodstream. Etymology
The term "space ebullism" was introduced by Captain Julian E. Ward in his paper "The True Nature of the Boiling of Body Fluids in Space", published in Aviation Medicine in October 1956. It was suggested "because the word ebullism does not connote the addition of heat to produce vapor." It comes from Latin ebullire, meaning "to bubble out, or to boil up."