Actas Dermo-Sifiliográficas (English Edition) Actas Dermo-Sifiliográficas (English Edition)
Actas Dermosifiliogr 2017;108:844-51 - Vol. 108 Num.9 DOI: 10.1016/
Original Article
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
A. Kelatia,, , 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
Received 03 February 2017, Accepted 07 May 2017
Related article:

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


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


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


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.


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


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.


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.


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


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.


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

Pigmented actinic keratosis, Facial lesions, Melanoma, Non-melanoma skin cancer, Dermoscopy
Palabras clave
Queratosis actínica pigmentada, Lesiones faciales, Melanoma, Cáncer de piel no melanoma, Dermatoscopia


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Actas Dermosifiliogr 2017;108:844-51 - Vol. 108 Num.9 DOI: 10.1016/
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