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Dermoscopy of Actinic Keratosis

Actinic keratosis is a very common skin diseases. It is a major growing public health problem especially among older adults in white. A meta-analysis of observational studies reported by British Association of Dermatologists showed that the overall prevalence of actinic keratosis worldwide was 14%, with an estimated incidence of 1,928 cases per 100,000 people per…

Actinic keratosis is a very common skin diseases. It is a major growing public health problem especially among older adults in white. A meta-analysis of observational studies reported by British Association of Dermatologists showed that the overall prevalence of actinic keratosis worldwide was 14%, with an estimated incidence of 1,928 cases per 100,000 people per year.

People in geographic locations with too much sun exposure are more likely to have actinic keratosis. Because there is a increasing tend that actinic keratosis translates into an risk of skin cancer, especially squamous cell carcinoma. Identifying patients at high risk for actinic keratosis and for timely and effective treatment of actinic keratosis are very important.

With the development of medical equipment, a small and flexible skin inspection tool, the dermoscope, emerged. Dermoscopy plays a crucial role in the early diagnosis, evaluation and treatment of actinic keratosis. Dermoscopy of actinic keratosis helps dermatologists make more timely and accurate analysis and judgment.Dermoscopy of actinic keratosis also enhances the confidence of doctors and patients in the treatment of actinic keratosis. Dermoscopy of actinic keratosis allows actinic keratosis to be treated more effectively.

Dermatoscope DE-4100

What is Actinic Keratosis?
Actinic keratosis (shorted call AK) is also know as solar keratosis. Actinic keratoses are very common, and many people have them. It is a skin disease usually caused by long time exposure to ultraviolet light from the sun. The disease may require medical intervention, including medication or surgery, to reduce symptoms and prevent further deterioration. The best way to prevent solar keratosis is to avoid excessive exposure to the sun.

What are the Clinical Features of Actinic Keratosis?
Actinic keratosis disorders the skin to appear in thick, rough patches, itching or burning, raised wart-like growth, tenderness or pain, inflammation, increased size or thickness, multiple lesions. Actinic keratosis usually occurs in areas frequently exposed to sunlight, such as the head, arms, ears, scalp, neck, hands, face, etc.

Causes of Actinic Keratosis
It is a high risk of solar keratosis to exposure to ultraviolet (UV) radiation from the sun in long time. There are also other factors resulting in solar keratosis as below:
Long-term sunlight exposure: Long-term exposure to ultraviolet radiation from the sun is the main factor of solar keratosis.
Fair skin: People with fair skin are more susceptible to actinic keratosis. Because fair skin is more easily to receive more harmful effects of UV radiation.
Age: Actinic keratos is more commonly occurs in the middle age and old age people. Because accumulated sun exposure over time increases the posibility of developing these lesions.
History of sunburn: Severe sunburn, particularly in childhood or adolescence, increases the risk of developing actinic keratosis later in life.
Weakened immune system: Conditions or medications that weaken the immune system may also contribute to the development of solar keratosis, as the body may not be able to repair skin damage caused by UV light.

High risk Groups and Evolution
People in white, the elderly, and outdoor workers etc, are high-risk groups for actinic keratosis.
Actinic keratosis is considered a precancerous lesion because if left untreated, it can develop into skin cancer, especially squamous cell carcinoma. It is important to evaluate actinic keratosis lesions by a dermatologist and treat solar keratosis promptly to reduce the risk of skin cancer.

Dermoscopy of Actinic Keratosis
The application of dermoscopy of actinic keratosis
Dermoscopy is a non-invasive tool used to examine skin lesions. There are some main applications of dermoscopy of actinic keratosis like below:
Improved visualization: Dermatoscopy allows dermatologists to examine solar keratosis lesions more clearly, like the morphological and structural details of the lesions.
Early detection: Dermoscopy helps early detection of solar keratosis lesions for timely intervention and treatment. Early detection is essential to prevent the progressing of actinic keratoss to skin cancer.
Monitor and Evaluation: Dermoscopy can monitor the progression of solar keratosis lesions over time and evaluate of the severity of keratosis.
Differentiation from other lesions: dermoscopy can show specific features such as white scales, telangiectasia, and irregular vascular structure more clearly. It helps to distinguish solar keratosis from benign lesions such as erythema, scale, ect.

dermoscope IBOOLO DE-400 dermatoscope

What are features of dermoscopy of actinic keratosis?
When using dermoscopy to examine actinic keratosis, several features may be observed:
Structure: Brown structure-less area, ring-shaped particle structure
Distribution: The distribution of abnormal blood vessels, such as distrubution in points, lines, etc.
Pattern: Rough and irregular surface, showing a strawberry-like pattern, a fine network of thin and dark lines
Color: Color changes such as brown or red patches, regular pigmentation, especially hyper pigmentation of hair follicle openings
Other features: redness or erythema, white or yellowish scales, small black dots similar to acne (blackheads)

Dermoscopy of actinic keratosis may vary from person to person in different populations. But the most of main or key features like above listed. Dermoscopy is much helpful to distinguish actinic keratosis from other skin diseases according to the key features of dermoscopy of actinic keratosis.

dermatoscopio view

The importance of timely detection and treatment of actinic keratosis
Prompt detection and treatment of solar keratosis can help protect skin health. Early treatment can prevent worsening of the condition, prevent serious complications, and reduce the risk of skin cancer. Actinic keratosis may develop into skin cancers such as squamous cell carcinoma. However,
Dermatoscopy plays a vital role in the assessment, diagnosis and treatment of solar keratosis, helping dermatologists provide personalized and effective care for patients with this common skin disorder. Dermoscopy of actinic keratosis is closely bound up the skin examinations.

Common treatment methods of actinic keratosis
By timely detection of dermoscopy of actinic keratosis lesions, appropriate treatment measures such as cryotherapy (freezing), topical drug therapy, photodynamic therapy, chemical exfoliation or surgical removal can be taken to reduce the risk of developing skin cancer. In addition, preventive measures such as sun protection (e.g. sunscreen, wearing protective clothing, avoiding peak hours of sun) and regular skin examinations can help prevent the development of new solar keratosis lesions.

Actinic keratosis is a precancerous skin lesion. if left untreated, it can not only affect the appearance of the skin, cause pain and discomfort and also increase the risk of other skin problems. Even worse, it may develop into skin cancer, such as squamous cell carcinoma. The dermoscopy of actinic keratosis plays a very important role in the early discovery and diagnosis, as well as the detection after diagnosis, and feedback on the effects of treatment. Therefore, it is vital to develop the habit of use of dermoscopy of actinic keratosis.In addition, paying more attention to sun protection and conducting regular skin examinations are also necessary in our daily life. All these measures should be used in cooperation to reduce the potential risks faced by patients, prevent the occurrence of skin cancer, and maintain the health of the skin.

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How can dermoscopy images be captured?

Dermoscopy images can be captured and stored in different ways, such as: • Using a smartphone or tablet with dermoscopic adapter, which consisted in the package.• Using a digital camera

Dermoscopy images can be captured and stored in different ways, such as:

• Using a smartphone or tablet with dermoscopic adapter, which consisted in the package.
• Using a digital camera with dermoscopic adapter, there’s 49mm screw size camera adapter available to order now.

Compatible phone/tablet models:
All iPhone models, 95% Android phones, 90% tablet. For phone/tablet size in 5.25-14mm

Compatible camera models:
All camera with built 49mm filter screw, such as Canon EOS 70D, 80D, 90D; Canon EOS R7, R10, R50, R100; Canon M100, M200, M50, Mark II; Canon G7X Mark III, Sony ZV-1

How can I connect my phone to my dermatoscope?

There’s universal phone adapter for all our dermoscopes. Please check the installation procedure bellow or watch operation guide. Smartphone Connector (1) Place phone adapter screw in the center of smartphone’s

There’s universal phone adapter for all our dermoscopes. Please check the installation procedure bellow or watch operation guide.

Smartphone Connector

(1) Place phone adapter screw in the center of smartphone’s main camera.
(2) Screw magnet attachment on phone adapter.
(3) Put dermoscope’s back ring and magnet attachment together

Take The Best Images

You need to adjust the focus ring after the dermoscpe connected on smartphone to get the best images.

How can I clean my dermoscopy after usage?

Cleaning your dermoscopy after usage is important to prevent cross-contamination and infection. The cleaning method may vary depending on the type and model of your dermoscopy, so you should always

Cleaning your dermoscopy after usage is important to prevent cross-contamination and infection. The cleaning method may vary depending on the type and model of your dermoscopy, so you should always follow the manufacturer’s instructions. However, some general steps are:

• Turn off and disconnect your dermoscopy from any power source or device.

• Wipe off any visible dirt or debris from the dermoscopy with a soft cloth or tissue.

• Disinfect the dermoscopy with an alcohol-based wipe or spray, or a disinfectant solution recommended by the manufacturer. Make sure to cover all surfaces, especially the lens and contact plate.

• Let the dermoscopy air dry completely before storing it in a clean and dry place.

• Do not use abrasive or corrosive cleaners, solvents, or detergents that may damage the dermoscopy.

• Do not immerse the dermoscopy in water or any liquid, unless it is waterproof and designed for immersion.

You should clean your dermoscopy after each use, or at least once a day if you use it frequently. You should also check your dermoscopy regularly for any signs of damage or malfunction, and contact the manufacturer or service provider if needed.

Polarized VS Non-polarized Dermoscopy

A dermoscopy is a device that allows the examination of skin lesions with magnificationand illumination. By revealing subsurface structures and patterns that are not visible tothe naked eye. It can

A dermoscopy is a device that allows the examination of skin lesions with magnificationand illumination. By revealing subsurface structures and patterns that are not visible tothe naked eye. It can improve the diagnose accuracy of skin lesions, such as melanoma,basal cell carcinoma, seborrheic keratosis, etc.

There are two main types of dermoscopy: Non polarized and polarized dermoscopy.We’ve fitted most of our dermoscopys with polarized and non-polarized light. They canbe used in multiple skin structures.

Non-polarized contact Mode

In non-polarized mode, the instrument can provide information about the superficialskin structures, such as milia-like cysts, comedo-like openings, and pigment in theepidemis.

The dermoscopy requires applying a liquid such as mineral oil or alcohol to the skin andplacing the lens in contact with the skin. This reduces surface reflection and enhancesthe view of subsurface structures.

Image with non-polarized light (DE-3100)

Polarized contact Mode

In polarized mode, the instrument allows for visualization for deeper skin structures,such as blood vessels, collagen, and pigment in the dermis.

The dermoscopy does not need to be in contact with the skin or use any liquid. Theirpolarized light can help to eliminate surface reflection and allow visualization ofvascular structures.

Image with polarized light (DE-3100)

Polarized non-contact Mode

The dermoscopy can also use polarized light to examine the skin without direct contact.

In polarized non-contact mode, the instrument allows for examination infected areasand lesions that are painful for the patient, or the difficult to contact pigmented lesions,such as nails and narrow areas.

The contact plate should be removed in this mode, and it does not require applying aliquid to the skin. As it doesn’t require pressure or fluid application on the skin, it canalso avoid cross-contamination and infection risk.

Image in polarized non-contact mode (DE-3100)

How effectiveness is dermoscopy

Compared with visual inspection, the dermoscopy can be used to capture and store skin lesion photos, which play an important role in early skin cancer examination. The dermoscopy allows the

Compared with visual inspection, the dermoscopy can be used to capture and store skin lesion photos, which play an important role in early skin cancer examination.

The dermoscopy allows the examination of skin lesions with magnification and illumination. This can be greatly avoiding the factors that cause interference to visual detection. Such as lighting, skin color, hair and cosmetics.

Several studies have demonstrated that dermoscopy is useful in the identification of melanoma, when used by a trained professional.

It may improve the accuracy of clinical diagnosis by up to 35%
It may reduce the number of harmless lesions that are removed
In primary care, it may increase the referral of more worrisome lesions and reduce the referral of more trivial ones

A 2018 Cochrane meta-analysis published the accuracy of dermoscopy in the detection.

Table 1. Accuracy of dermoscopy in the detection of melanoma in adults
Detection Method Sensitivity, % Specificity, % Positive Likelihood Ratio NegativeLikelihood Ratio
Visual inspection alone (in person) 76 75 3.04 0.32
Dermoscopy with visual inspection (in person) 92 95 18 0.08
Image-based visual inspection alone (not in person) 47 42 0.81 1.3
Dermoscopy with image-based visual inspection (not in person) 81 82 4.5 0.23
ROC—receiver operating characteristic. *Estimated sensitivity calculated on the summary ROC curve at a fixed specificity of 80%.

As we can see, the dermoscope can improve the accuracy of diagnosis of skin lesions, especially melanoma.

Table 1. Accuracy of dermoscopy in the detection of melanoma in adults
Detection Method Sensitivity, % Specificity, % Positive Likelihood Ratio NegativeLikelihood Ratio
Visual inspection alone (in person) 79 77 3.4 0.27
Dermoscopy with visual inspection (in person) 93 99 93 0.07
Image-based visual inspection alone (not in person) 85 87 6.5 0.17
Dermoscopy with image-based visual inspection (not in person) 93 96 23 0.07
ROC—receiver operating characteristic. *Estimated sensitivity calculated on the summary ROC curve at a fixed specificity of 80%.

Characteristics of the dermatoscopic structure of the skin lesions include:

• Symmetry or asymmetry
• Homogeny/uniformity (sameness) or heterogeny (structural differences across the lesion)
• Distribution of pigment: brown lines, dots, clods and structureless areas
• Skin surface keratin: small white cysts, crypts, fissures
• Vascular morphology and pattern: regular or irregular
• Border of the lesion: fading, sharply cut off or radial streaks
• Presence of ulceration

There are specific dermoscopic patterns that aid in the diagnosis of the following pigmented skin lesions:

• Melanoma
• Moles (benign melanocytic naevus)
• Freckles (lentigos)
• Atypical naevi
• Blue naevi
• Seborrhoeic keratosis
• Pigmented basal cell carcinoma
• Haemangioma

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