Dermoscopy of Actinic Keratosis: Is There a True Differentiation between Non-Pigmented and Pigmented Lesions?

Dermoscopic features of actinic keratosis (AK) have been widely studied, but there is still little evidence for their diagnostic accuracy. Our study investigates whether established dermoscopic criteria are reliable predictors in differentiating non-pigmented actinic keratosis (NPAK) from pigmented actinic keratosis (PAK). For this purpose, dermoscopic images of 83 clinically diagnosed AK (45 NPAK, 38PAK) were examined, and the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) were assessed. Features with statistical significance were the red pseudo-network (p = 0.02) for NPAK and the pigmented pseudo-network (p < 0.001) with a pigment intensity value even less than 10% for PAK (p = 0.001). Pigmented pseudo-network (Se: 89%, Sp: 77%, PPV: 77%, NPV: 89%) with a pigment intensity value of more than 10% (Se: 90%, Sp: 86%, PPV: 79%, NPV: 93%) had excellent diagnostic accuracy for PAK. Scale and widened follicular openings with yellowish dots surrounded by white circles were equally represented in both variants of AK. Linear wavy vessels and shiny streaks were more prominently observed in NPAK, as were rosettes in PAK, but these results failed to meet statistical significance. The red starburst pattern was near statistical significance for PAK. Therefore, pigmentation is the strongest dermoscopic predictor for the differentiation between NPAK and PAK.

Actinic Keratoses (AK): An Exploratory Questionnaire-Based Study of Patients' Illness Perceptions.

BACKGROUND: Decreased illness perception among actinic keratoses (AK) patients is a major barrier to the effective management of AK. OBJECTIVE: We aimed to investigate patients' illness and treatment perceptions, their correlation to demographics and AK/skin cancer history, and secondarily the influence of these perspectives on treatment and sunscreen use. MATERIALS AND METHODS: Participants completed questionnaires based on the Brief Illness Perception Questionnaire and statistical analysis was performed. RESULTS: In total, 208 AK patients were enrolled. A large proportion were poorly aware of the disease (41.4%), with less than half (43%) being familiar with AK. Patients were aware of the chronic nature of the disease and its correlation to sunlight regardless of demographic characteristics. The level of education played a role in disease awareness (p = 0.006), and treatment plan perception (p = 0.002). The increase in sunscreen protection after AK diagnosis was higher in women (p = 0.009) and younger patients (p = 0.044). Patients' concerns regarding treatment were mainly related to the duration (30%) and effectivity (25%). Dermatologists' statements highlighting that AK are precancerous lesions (86.2%) influenced patients' willingness for treatment. CONCLUSION: Improved awareness of AK is necessary to increase treatment seeking and compliance, regarding both treatment and sunscreen use. Dermatologists' statements may have critical influence on patients' decisions to receive treatment for AK.

The Effectiveness of Cryosurgery Combined with Curettage and Electrodessication in the Treatment of Keratoacanthoma: A Retrospective Analysis of 90 Cases.

BACKGROUND: There are several treatment options for keratoacanthoma (KA). However, there are limited data available on the use of cryosurgery. OBJECTIVE: To evaluate the effectiveness and safety of a combination treatment for KA and to evaluate the cosmetic outcome. MATERIALS AND METHODS: The combination treatment incorporates the use of curettage, electrodessication, and cryotherapy. A retrospective study was conducted on 90 patients with KA who had been treated with this method between 2000 and 2014. The follow-up period lasted 2 years and photographs were available for every visit of the patients to the department. RESULTS: The success rate was found to be 97.8%. No serious adverse events were observed. No infections were reported. The cosmetic outcome was evaluated as excellent for all patients. DISCUSSION: The combination method appears to combine the advantages of both destructive treatment and surgical excision. It appears to be a safe and effective treatment method. However, there are certain limitations to this study. CONCLUSIONS: More studies are needed to evaluate the effectiveness and safety of this method.