Document Detail

Dermatoscopy of flat pigmented facial lesions: diagnostic challenge between pigmented actinic keratosis and lentigo maligna.
MedLine Citation:
PMID:  21083845     Owner:  NLM     Status:  In-Process    
BACKGROUND: The similarity between clinical pictures of pigmented actinic keratosis (PAK) and lentigo maligna (LM) is well known.
OBJECTIVES: 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.
METHODS: 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.
RESULTS: 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%).
CONCLUSIONS: 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.
B N Akay; P Kocyigit; A O Heper; C Erdem
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of dermatology     Volume:  163     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1212-7     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. BJD © 2010 British Association of Dermatologists.
Departments of Dermatology Pathology, University of Ankara School of Medicine, Samanpazari 06100, Ankara, Turkey.
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