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Dermoscopy effectively diagnosed actinic keratosis in real time

Dermoscopy used as a real-time noninvasive imaging technique displayed sensitivity and specificity in diagnosing actinic keratosis, according to study results.

Researchers in Madrid, Spain, studied 178 patients (mean age, 67 years; 64.6%, men) with 178 actinic keratosis (AK) lesions. The independent, masked study compared dermoscopy results and histopathological findings, considered the gold standard for diagnosis of AK, with all patients undergoing both tests.

Facial lesions were most frequent (n=139; 78.1%), followed by the scalp (n=36; 20.2%), with the remainder on the back or upper extremities. Dermoscopy diagnoses and histopathological findings had a concordance of 0.917. Dermoscopy displayed sensitivity for AK diagnosis of 98.7% and a specificity of 95.0%, a positive likelihood ratio of 19.74 and a negative likelihood ratio of 0.01. False-positive results showed a proportion of 5.0% and false-negative results 1.3%. Follicular openings combined with erythematosus pseudonetwork in a diagnostic algorithm demonstrated a sensitivity of 95.6% and specificity of 95.0% for diagnosing AK.

“The findings … have major practical applications in the field of skin cancer,” the researchers concluded. “This noninvasive technique can be performed in the office as part of daily clinical practice and provides immediate results, with consequent prognostic and therapeutic implications. Because dermoscopy is not a costly technique, its use is important … for the health system.

“Dermoscopy may be incorporated as a noninvasive strategy for the diagnosis of AK and in the management of patients with these lesions.”