Abstract
The study examines the changes in dermoscopic features of actinic keratosis (AK) after photodynamic therapy, and delineates the association between AK dermoscopic and histopathological findings. A total of 21 patients (23 lesions) with pathologically confirmed actinic keratosis who received 5-aminolaevulinic acid (ALA) photodynamic therapy (ALA-PDT) were enrolled. The numbers of PDT treatments were: 1, n=1; 2, n=2; 3, n=10; 4, n=6; 5, n=2; 6, n=2). The dermoscopic features before and after the PDT were compared. There were statistically significant decreases in the positive rates of dermoscopic features including scales (P<0.001), follicular plugs with whitish halo (P=0.013), and red pseudonetwork (P=0.022) among patients treated with ALA-PDT. Dermoscopic feature was significantly associated with pathological grade (P<0.001). Histopathological hyperkeratosis was significantly associated with dermoscopic red pseudonetwork (P=0.034) and wavy vessel (P=0.005). Parakeratosis was associated with wavy vessels (P=0.001). For vascular hyperplasia in dermal papillae, the significant correlates included scales (P=0.011), follicular plugs with whitish halo (P=0.011), red pseudonetwork (P<0.001); coiled vessels (P=0.003) and rosette sign (P=0.004). Wavy vessels was the only feature correlating keratosis pilaris (P=0.003). The findings of the present study support dermoscopy as having potential to be useful for diagnosing and monitoring of actinic keratosis.
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