Dermatoscopic Patterns of Nonfacial Actinic Keratosis: Characterization of Pigmented and Nonpigmented Lesions

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Actinic keratoses (AKs) are dysplastic proliferations of keratinocytes. Studies evaluating nonfacial dermatoscopic pattern of AKs are scarce.


This study aimed to evaluate the dermatoscopic patterns of AKs located in nonfacial sites and to compare their patterns with facial lesions.


Patients with concomitant facial and nonfacial AKs were recruited to participate and evaluated by clinical and dermatoscopic images of their AKs.


Sixty-eight patients were included in the study. A total of 258 nonfacial AKs and 68 facial AKs were analyzed. The most frequent nonfacial AK dermatoscopic structures were white opaque scales (97.3%) and erythema (57.4%). When analyzed in combination, white scales plus erythema were found in 55.4% of nonfacial AKs. Pigmented structures were observed in 22.5% nonfacial AKs. Homogeneous brown pigmentation was the most prevalent pigmented structure in nonfacial pigmented AK (pAK) (93.1%). There was a positive association between patients having concomitant pigmented facial and nonfacial AKs (p < .001).


The combinations of erythema and white opaque scales or yellow opaque scales and homogeneous pigmentation are suggestive, respectively of nonpigmented and pigmented nonfacial AKs. Pigmented AKs occur concomitantly in facial and nonfacial areas.

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