An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis—A Narrative Review
Abstract
:1. Introduction
1.1. Introduction to NMSC
1.2. Demographics and Clinical Presentation of AKs
1.3. Pathogenesis of AK
1.4. Classification and Grading of AK
1.5. Treatment of AK
2. Actinic Keratosis in Dermoscopy
2.1. Actinic Keratosis in High Frequency Ultrasonography (HFUS)
2.2. Actinic Keratosis in Reflectance Confocal Microscopy (RCM)
2.3. Actinic Keratosis in Optical Coherence Tomography (OCT)
New Perspectives
3. Summary
Dermatoscopy | HFUS | RCM | OCT | HD-OCT | |
---|---|---|---|---|---|
Findings | In grade one AK, a pattern of pink or red pseudonetwork with discrete white scales. Grade two: an erythematous background alongside white or yellow, keratinized and wide hair follicles (commonly known as the “strawberry pattern”). Grade three: wide hair follicles filled with keratinized masses on a scaly, white-yellow background. Other: four dots, visible only under polarized light, commonly referred to as “rosettes” (only seen in polarized mode), shiny streaks, and linear, wavy vessels surrounding the hair follicles. Pigmented variant of AK: a brown pseudonetwork and granular-annular homogeneous areas. | Round to oval structures with a sharp border between the base of the hypoechogenic tumour and the surrounding hyperechogenic dermis. Hyperkeratotic scales are characterized by thickened hyperechoic line or perpendicular shadow located in the epidermis. | In grade 1: focal areas of atypical honeycomb pattern at the level of the stratum spinosum, interspersed with areas of preserved, regular honeycomb pattern. Grade 2 AK: the atypia of keratinocytes is more severe, involves the stratum spinosum and granulosum layers, and is accompanied by different sizes of cells and shapes. Grade 3: a markedly atypical honeycomb pattern with areas of partially disrupted epidermis, referred to as a disarranged pattern. | The presence of a dark band (associated with epidermal thinning), hyperreflective streaks and dots, probably corresponding to dense, hyperkeratotic areas, disruptions in the epidermis and vascular reticulation. | An atypical honeycomb pattern confined to the lower 1/3 of the epidermis, correlates with early lesions and KIN-I. Atypical keratinocytes provoking an atypical honeycomb pattern involves mostly the lower 2/3 of the epidermis, while full thickness atypia in the epidermis and chaos without honeycomb pattern are consistent with KIN-III. |
Funding
Conflicts of Interest
References
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Korecka, K.; Kwiatkowska, D.; Mazur, E.; Dańczak-Pazdrowska, A.; Reich, A.; Żaba, R.; Polańska, A. An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis—A Narrative Review. Medicina 2024, 60, 1043. https://doi.org/10.3390/medicina60071043
Korecka K, Kwiatkowska D, Mazur E, Dańczak-Pazdrowska A, Reich A, Żaba R, Polańska A. An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis—A Narrative Review. Medicina. 2024; 60(7):1043. https://doi.org/10.3390/medicina60071043
Chicago/Turabian StyleKorecka, Katarzyna, Dominika Kwiatkowska, Ewelina Mazur, Aleksandra Dańczak-Pazdrowska, Adam Reich, Ryszard Żaba, and Adriana Polańska. 2024. "An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis—A Narrative Review" Medicina 60, no. 7: 1043. https://doi.org/10.3390/medicina60071043