title: Dermoscopy of facial nonpigmented actinic keratosis.
abstract: BACKGROUND
  The accuracy of clinical diagnosis of nonpigmented, facial actinic keratosis (AK) is often suboptimal, even for experienced clinicians.
  
  
  OBJECTIVE
  To investigate the dermoscopic features of nonpigmented AK located on the head/neck that may assist the clinical diagnosis.
  
  
  METHODS
  Forty-one nonpigmented AKs on facial sites were examined by dermoscopy for any consistent underlying features. Lesions were gathered from skin cancer centres in Australia, Austria, Italy and the U.S.A. All cases were diagnosed histopathologically.
  
  
  RESULTS
  Four essential dermoscopic features were observed in facial AK: (i) erythema, revealing a marked pink-to-red 'pseudonetwork' surrounding the hair follicles (95%); (ii) white-to-yellow surface scale (85%); (iii) fine, linear-wavy vessels surrounding the hair follicles (81%); and (vi) hair follicle openings filled with yellowish keratotic plugs (66%) and/or surrounded by a white halo (100%). These features combined, in 95% of cases, to produce a peculiar 'strawberry' appearance.
  
  
  CONCLUSIONS
  A dermoscopic model of 'strawberry' pattern is presented, which may prove helpful in the in vivo diagnosis of nonpigmented, facial AK. A limitation of this study is the lack of testing of the specificity of the described dermoscopic criteria in differentiating nonpigmented AKs from other nonpigmented skin lesions at this site.
authors.affiliation: Mends St Medical Centre, South Perth, Western Australia. iris.zalaudek@meduni-graz.at
authors.forename: I
authors.initials: I
authors.lastname: Zalaudek
authors.forename: J
authors.initials: J
authors.lastname: Giacomel
authors.forename: G
authors.initials: G
authors.lastname: Argenziano
authors.forename: R
authors.initials: R
authors.lastname: Hofmann-Wellenhof
authors.forename: T
authors.initials: T
authors.lastname: Micantonio
authors.forename: A
authors.initials: A
authors.lastname: Di Stefani
authors.forename: M
authors.initials: M
authors.lastname: Oliviero
authors.forename: H
authors.initials: H
authors.lastname: Rabinovitz
authors.forename: H P
authors.initials: HP
authors.lastname: Soyer
authors.forename: K
authors.initials: K
authors.lastname: Peris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D046169:Dermoscopy / Q000379:methods*; D004890:Erythema / Q000209:etiology / Q000473:pathology; D005148:Facial Dermatoses / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D018859:Hair Follicle / Q000473:pathology; D006801:Humans; D007642:Keratosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010787:Photosensitivity Disorders / Q000175:diagnosis* / Q000473:pathology; D010865:Pilot Projects; D012880:Skin Pigmentation