Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis

Lallas, A., Tschandl, P., Kyrgidis, A., Stolz, W., Rabinovitz, H., Cameron, A., Gourhant, J.Y., Giacomel, J., Kittler, H., Muir, J., Argenziano, G., Hofmann-Wellenhof, R. and Zalaudek, I. (2016) Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis. British Journal of Dermatology, 174 5: 1079-1085. doi:10.1111/bjd.14355

Author Lallas, A.
Tschandl, P.
Kyrgidis, A.
Stolz, W.
Rabinovitz, H.
Cameron, A.
Gourhant, J.Y.
Giacomel, J.
Kittler, H.
Muir, J.
Argenziano, G.
Hofmann-Wellenhof, R.
Zalaudek, I.
Title Dermoscopic clues to differentiate facial lentigo maligna from pigmented actinic keratosis
Journal name British Journal of Dermatology   Check publisher's open access policy
ISSN 1365-2133
Publication date 2016-05-01
Sub-type Article (original research)
DOI 10.1111/bjd.14355
Open Access Status Not Open Access
Volume 174
Issue 5
Start page 1079
End page 1085
Total pages 7
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Language eng
Formatted abstract
Background: Dermoscopy is limited in differentiating accurately between pigmented lentigo maligna (LM) and pigmented actinic keratosis (PAK). This might be related to the fact that most studies have focused on pigmented criteria only, without considering additional recognizable features.

Objectives: To investigate the diagnostic accuracy of established dermoscopic criteria for pigmented LM and PAK, but including in the evaluation features previously associated with nonpigmented facial actinic keratosis.

Methods: Retrospectively enrolled cases of histopathologically diagnosed LM, PAK and solar lentigo/early seborrhoeic keratosis (SL/SK) were dermoscopically evaluated for the presence of predefined criteria. Univariate and multivariate regression analyses were performed and receiver operating characteristic curves were used.

Results: The study sample consisted of 70 LMs, 56 PAKs and 18 SL/SKs. In a multivariate analysis, the most potent predictors of LM were grey rhomboids (sixfold increased probability of LM), nonevident follicles (fourfold) and intense pigmentation (twofold). In contrast, white circles, scales and red colour were significantly correlated with PAK, posing a 14-fold, eightfold and fourfold probability for PAK, respectively. The absence of evident follicles also represented a frequent LM criterion, characterizing 71% of LMs.

Conclusions: White and evident follicles, scales and red colour represent significant diagnostic clues for PAK. Conversely, intense pigmentation and grey rhomboidal lines appear highly suggestive of LM.
Keyword Dermoscopy
Diagnostic accuracy
Dermoscopic criteria
Facial lentigo maligna
Pigmented actinic keratosis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Discipline of General Practice Publications
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