These single or multiple, discrete, dry, rough, adherent scaly lesions occur on the habitually sun-exposed skin of adults, usually on a background of dermatoheliosis. Erythematous macules and papules with coarse, adherent scale become confluent on this bald scalp with dermatoheliosis. These hyperkeratoses are yellowish-greyish and have a tinge of hemorrhage; gently abrading lesions with a fingernail usually induces pain, even in early subtle lesions, a helpful diagnostic finding.