Actinic keratosis is a precancerous cutaneous neoplasm consisting of proliferations of cytologically abnormal epidermal keratinocytes that develop in response to prolonged exposure to ultraviolet radiation. Cumulative exposure to ultraviolet radiation is the major risk factor for developing actinic keratosis. Although over 80% of all actinic keratoses are distributed on habitually sun-exposed areas such as head, neck, forearms and dorsal hands, disseminated forms of actinic keratosis also have been rarely reported. A 69 year-old woman presented with multiple scaly brownish papules and plaques on the upper and lower extremities which has lasted for 10 years. Multiple hyperkeratotic, well-circumscribed lesions were distributed on the lower legs. Punch biopsy was performed under the impression of disseminated superficial actinic porokeratosis (DSAP). Histological examination revealed hyperkeratosis of the lesion showing smooth transition without cornoid lamella. Pleomorphic and hyperchromatic basal keratinocytes and solar elastosis of the dermis were consistent with actinic keratosis. The lesions showed clinical improvement after repeated cryotherapy. Herein, we report an interesting case of disseminated actinic keratosis, which showed an unusual clinical presentation.