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Dermatoscopic patterns show specific characteristics in nonfacial actinic keratosis

Dermatoscopic patterns showed specific characteristics of nonpigmented and pigmented nonfacial actinic keratosis when compared with facial actinic keratosis, according to study results published in Dermatologic Surgery.

Researchers studied 68 patients (mean age, 71 years; 55.9% men) with concomitant nonfacial and facial actinic keratosis (AK) between April and November 2015. They used a digital nonpolarized light video-dermatoscope (Fotofinder dermoscope Medicam 500, Fotofinder Systems) for clinical and dermatoscopic images of all lesions.

Sixty-four patients presented with multiple AKs with phototypes ranging from II to III.

There were 258 nonfacial AKs and 68 facial AKs evaluated, with nonfacial AKs located on the forearms (106 lesions), hands (147 lesions) legs and foot.

White opaque scales (97.3%) and erythema (57.4%) were the most frequent nonfacial AK dermatoscope structures.

“When analyzed in combination, white scales plus erythema were found in 55.4% of nonfacial AKs,” the researchers wrote.

Nonfacial AKs included 22.5% with pigmented structures, with homogenous brown pigmentation the most prevalent pigmented structure in the nonfacial pigmented AK (93.1%).

In patients with facial AK, red pseudonetwork was found in 54 lesions (79.2%), white opaque scales were found in 62 lesions (91.2%) and erythema found in 15 lesions (22.1%).

There was a statistically significant association between having nonfacial pigmented AK and facial pigmented AK (P < .001).

“The combination of erythema plus white opaque scales and of white opaque scales plus pigmentation are suggestive for the diagnosis of nonfacial AK by dermatoscopy,” the researchers concluded. “The classic red pseudonetwork, well described in previous studies was the most commonly observed pattern in facial AK.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.