### Patient: I have been experiencing some scaly patches on my face and arms. It is usually itchy and painful. I am worried that it might be something serious. 
### Doctor: Based on your description, it sounds like you may have Actinic keratosis. To confirm this, I recommend a complete physical skin exam performed to fully assess the affected areas. Afterward, we may have to do a biopsy and other diagnostic procedures on the skin and subcutaneous tissues. Depending on the severity, treatment may require excision of the skin lesion or other therapeutic procedures. We will also need to manage the wound care properly.