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- Title
Dermatoscopy of flat pigmented facial lesions: diagnostic challenge between pigmented actinic keratosis and lentigo maligna B.N. Akay et al. Dermatoscopy of pigmented actinic keratosis.
- Authors
Akay, B. N.; Kocyigit, P.; Heper, A. O.; Erdem, C.
- Abstract
The similarity between clinical pictures of pigmented actinic keratosis (PAK) and lentigo maligna (LM) is well known. To investigate the frequency of dermatoscopic findings suggestive of LM/lentigo maligna melanoma (LMM) in the other facial pigmented skin lesions (FPSL) and to assess the distinguishing dermoscopic criteria of PAK and LM. Eighty-nine FPSL were evaluated with conventional dermatoscopy. The lesions showing one or more dermatoscopic features considered as specific patterns for the diagnosis of LM/LMM, mainly slate-grey to black dots and globules, slate-grey areas, annular-granular pattern, asymmetrical pigmented follicular openings, black blotches, rhomboidal structures, hyperpigmented rim of follicular openings, slate-grey streaks and dark streaks, were included in the study selectively. PAK was diagnosed in 67, LM or LMM in 20 and lichen planus-like keratosis in two lesions, histopathologically. Eleven essential dermatoscopic features were observed in facial PAK: slate-grey dots (70%); annular-granular pattern (39%); rhomboidal structures (36%); pseudonetwork (36%); black globules (34%); slate-grey globules (33%); black dots (30%); asymmetrical pigmented follicular openings (25%); hyperpigmented rim of follicular openings (21%); slate-grey areas (18%); and streaks (3%). PAK has a striking similarity to LM/LMM in clinical and dermatoscopic features, thus representing a diagnostic challange. All dermatoscopic findings except black blotches were observed in PAK. As dermatoscopic diagnosis of a pigmented skin lesion cannot be based on the presence of a single criterion, we may conclude that histopathology still remains the gold standard for correct diagnosis.
- Subjects
ACTINIC keratosis; KERATOSIS; SKIN disease diagnosis; FACE diseases; MAXILLOFACIAL surgery; HISTOPATHOLOGY; DERMATOLOGY
- Publication
British Journal of Dermatology, 2010, Vol 163, Issue 6, p1212
- ISSN
0007-0963
- Publication type
Article
- DOI
10.1111/j.1365-2133.2010.10025.x