pigmented actinic keratosis
TRANSCRIPT
Pigmented actinic keratosis simulating a
Lentigo maligna.
F. Peral Rubio, M.D.Department of Dermatology Hospital Universitario Virgen Macarena, Seville, Spain
Pigmented actinic keratosis simulating a Lentigo maligna.
A 56-years-old men. The patient was referred to us
for the assessment of a pigmented lesion on the cheek 7 years previously.
Pigmented actinic keratosis simulating a Lentigo maligna
The dermoscopy revealed: In the upper
-Slate gray and brown dots .
-Annular granular pattern of gray dots.
-Asymmetric pigmented follicular openings In the middle and lower:
- Erythematous pseudonetwork, in which there are prominent hair follicles surrounded by a white halo.
Annular granular pattern of gray dots
Slate gray and brown dots
Asymmetric pigmented follicular openings
Erythematous pseudonetwork
Pigmented actinic keratosis simulating a Lentigo maligna
A biopsy was performed on the pigmented area and pathology revealed a pigmented actinic keratosis.
Pigmented actinic keratosis simulating a Lentigo maligna
Dermoscopy of no pigmented actinic keratosis:Typical feature is a composite pattern
named “strawberry” characterized by:
• A erythematous pseudonetwork on facial skin, in which there are prominent hair follicles surrounded by a white halo.
• If the folllicle has a yellow central plaque they may look like a target.
Pigmented actinic keratosis simulating a Lentigo maligna
Dermoscopy of pigmented actinic keratosis: Facial pigmented actinic keratosis is a differential
diagnosis of lentigo maligna because it can have the same clinical and dermoscopic aspects:
• Gray or brown dots and globules.• Asymmetric pigmented follicles.• Annular-granular structures.• Possible clues for pigmented actinic keratosis
are scales and a superficial broken-up network usually not present in lentigo maligna.
Pigmented actinic keratosis simulating a Lentigo maligna
Conclusions The dermatoscopical picture of pigmented
actinic keratosis in this patient was practically indistinguishable from the early stage of Lentigo Maligna.
Pigmented actinic keratosis has a striking similarity to lentigo maligna in clinical and dermatoscopic features, thus representing a diagnostic challange.
Pigmented actinic keratosis simulating a
Lentigo maligna.
F. Peral Rubio, M.D.Department of Dermatology Hospital Universitario Virgen Macarena, Seville, Spain