Actinic keratosis (AK) is a common precursor of sun-related squamous cell carcinoma. AK is difficult to be differentiated from other malignancies with the naked eyes. Dermoscopic features of AK were previously described in some studies, but not extensively investigated. We investigated the dermoscopic features of AK in Asians and assessed dermoscopy as a post-treatment monitoring tool of AK. We retrospectively examined 34 AK lesions which had been diagnosed by histology. The changes of dermoscopic features and histopathological findings were assessed in all these lesions before and after treatment. Before treatment, 18 lesions were pigmented and 16 lesions were non-pigmented AK dermoscopically. The frequent dermoscopic features of AK were keratin/ scales (79.4%), red pseudonetwork (73.5%), targetoid-like appearance (55.9%), rosette sign (38.2%) and absent fissures/ridges, crypts and milia-like cysts. All the lesions had been treated with either photodynamic therapy, cryotherapy or 5% imiquimod cream. After treatment, dermoscopic features of 33 AK lesions were decreased or disappeared, and skin biopsies confirmed that atypical keratinocytes disappeared. One lesion showed accentuated and new dermoscopic features after treatment, and skin biopsy also showed progressing squamous cell carcinoma. In conclusion, scales, red pseudonetwork, targetoid-like appearance and rosette sign were common dermoscopic findings of AK in Asians. In most cases, the treatment response correlated with the changes in dermoscopic features. These findings suggest that dermoscopy is a useful tool to monitor AK.

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Background: Laser-assisted liposuction (LAL) is currently widely used to reduce localized fat. A novel Nd:YAG laser that uses a wavelength of 1,444 nm, which is better absorbed by fat, has recently been introduced. In this study, we investigated the efficacy of 1,444-nm Nd:YAG LAL for the treatment of gynecomastia. Patients and Methods: Thirteen Korean male patients (20-28 years, mean age 23 years) diagnosed with gynecomastia were enrolled in this study. All patients were treated by LAL with 1,444-nm Nd:YAG laser (100 µs pulse width, 40 Hz frequency, 300 mJ pulse energy and 12 W power with continuous emission) after tumescent anesthetic infiltration and were then evaluated. Outcome was assessed using the following 4 methods: (1) clinical assessment with photographs obtained before and 12 weeks after LAL treatment, (2) comparison of pre- and postoperative patient chest circumferences, (3) computed tomography (CT) scans to evaluate changes in breast thickness and (4) a patient satisfaction survey at the end of the study. Results: After 12 weeks, most patients (84.5%) showed an improvement greater than 50%. Mean chest circumference was significantly reduced from 109.6 ± 8.2 to 101.2 ± 4.4 cm 12 weeks after LAL (p < 0.001). CT scans showed a significant reduction in mean breast thickness from 22.7 ± 3.2 to 15.6 ± 2.4 mm (p = 0.016). Side effects (pain, edema, numbness and ecchymosis) were minimal and disappeared shortly after the first manifestation. Conclusion: Gynecomastia can be safely treated with 1,444-nm Nd:YAG LAL to reduce fatty tissue and total breast volume.

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