Actinic keratosis (AK) is so common — we tend to see it, treat it and move on. We don’t think about the name or why it’s named what it is. (Nor do we tend to think a lot about the biology behind AK.) The name wasn’t chosen because of its biology or pathology but because of its crusty texture. In truth, it’s a misnomer. It’s not a keratosis like a seborrheic keratosis but instead an evolving malignancy. In my opinion, as well as that of many others, it’s time to change the name of this lesion to reflect what it is rather than the way it feels.