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Vol. 108. Num. 9.November 2017
Pages e57-e62Pages 795-888
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Vol. 108. Num. 9.November 2017
Pages e57-e62Pages 795-888
Original Article
DOI: 10.1016/j.ad.2017.05.002
Dermoscopy of Pigmented Actinic Keratosis of the Face: A Study of 232 Cases
Dermatoscopia en la queratosis actínica pigmentada del rostro: estudio de 232 casos
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A. Kelatia,
Corresponding author
awatkelati@gmail.com

Corresponding author.
, H. Baybaya, E. Moscarellab, G. Argenzianob, S. Gallouja, F.Z. Mernissia
a Department of Dermatology, University Hospital Hassan II, Fez, Morocco
b Department of Dermatology, Second University of Naples, Naples, Italy
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Actas Dermosifiliogr 2017;108:79810.1016/j.ad.2017.07.005
P. Zaballos Diego
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Table 1. Classification and definitions of the dermoscopic patterns examined in our study.
Table 2. The epidemiological and the clinical characteristics of the patients.
Table 3. Univariate analysis showing the patients characteristics significantly related to the dermoscopic features.
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Abstract

The diagnosis of pigmented actinic keratosis (PAK) is often challenging because of overlapping features with lentigo maligna.

Objective

To investigate dermoscopic patterns of PAK according to their different evolutionary stages, and to correlate the pattern with clinical characteristics of the patients.

Methods

Descriptive and analytical study of 232 PAK. Dermoscopic patterns were divided into two categories: the follicule surroundings’ abnormalities (FSA) and follicular keratosis’ abnormalities (FKA).

Results

FSA and FKA dermoscopic patterns were related to male gender, except for star-like appearance, double white clods and dermoscopic horn (p0.04). Rhomboidal, annular granular pattern, gray halo, white circle and double clods were dermoscopic pattern significantly related to xeroderma pigmentosum's type of skin. Based on the evolutionary stages of PAK, the jelly sign was significantly related to thin patches of PAK. Central crusts and scales were related to thick plaques and the star-like appearance to hypertrophic PAK. The presence of 2 or more dermoscopic signs in both FSA and FKA was noticed in 99.1% of lesions.

Conclusions

The dermoscopic diagnosis of PAK vary according to the evolutionary stages of the disease, this will increase the diagnosis accuracy, with therapeutic implications.

Keywords:
Pigmented actinic keratosis
Facial lesions
Melanoma
Non-melanoma skin cancer
Dermoscopy
Resumen

El diagnóstico de la queratosis actínica pigmentada (QAP) es a menudo difícil, debido a sus características, que se solapan con las propias del lentigo maligno.

Objetivo

Investigar los patrones dermatoscópicos de la QAP con arreglo a sus distintos estadios evolutivos, y correlacionar dicho patrón con las características clínicas de los pacientes.

Métodos

Estudio descriptivo y analítico de 232 QAP. Se dividieron los patrones dermatoscópicos en 2 categorías; alteraciones perifoliculares (APF) y la queratosis folicular (QF).

Resultados

Se relacionaron los patrones dermatoscópicos de APF y QF con el sexo masculino, exceptuando las características de aspecto estrellado, double white clods y cuerno dermatoscópico (p0,04). Las características romboidal, anular-granular, de halo gris, círculo blanco y double clots constituyeron los patrones dermatoscópicos significativos relacionados con el tipo de piel del xeroderma pigmentoso. Sobre la base de los estadios evolutivos de la QAP, el signo de la jalea guardó relación significativa con los parches finos cutáneos de la QAP. Las costras y escamas centrales se relacionaron con las placas densas, y el aspecto estrellado de la QAP hipertrófica. La presencia de 2 o más signos dermatoscópicos, tanto en APF como en QF, se apreció en el 99,1% de las lesiones.

Conclusiones

El diagnóstico dermatoscópico de QAP varía con arreglo a los estadios evolutivos de la enfermedad, incrementándose la precisión diagnóstica, con implicaciones terapéuticas.

Palabras clave:
Queratosis actínica pigmentada
Lesiones faciales
Melanoma
Cáncer de piel no melanoma
Dermatoscopia
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