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Pigmented actinic keratosis

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Pigmented actinic keratosis

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

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