Tests
Tests to consider
dermoscopy
Test
Only required if the clinical exam findings are not typical of AK.
Performed only to confirm clinical diagnosis and rule out other skin conditions.
Result
strawberry pattern (erythematous background, pink-to-red pseudo-network, thin undulated vessels surrounding hair follicles, white-to-yellow scale, hair follicles filled with yellowish keratotic plugs, surrounded by a white halo). Possible early signs of progression of facial AKs to squamous cell carcinoma (SCC) include dotted vessels surrounding hair follicles, starburst pattern, and coalescence of keratotic follicles
skin biopsy
Test
Only required if the clinical exam and dermoscopy findings are not typical of AK and there is a suspicion of progression to SCC.
Histologically, 5 types: hypertrophic, atrophic, Bowenoid, acantholytic, pigmented (large amounts of melanin, particularly in basal keratinocytes).[54]
Result
histologic changes of intraepidermal keratinocytic dysplasia
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