that red pseudo-network appearance was significantly associated with AK, whereas dotted ⁄ glomerular vessel, diffuse yellow opaque scales and micro erosions were significantly more prevalent among intra-epidermal carcinoma. We found that scaling is an important dermatoscopic feature in AK especially in grade 3 lesions. Similar to these results, Zalaudek et al. declared that yellow-white opaque scale and diffuse discrete scales more prominent in intra-epidermal carcinoma than AK. And also central scales were found more common in intra-epidermal carcinoma and squamous cell carcinoma. 4 We have to emphasize that dermatoscopic pattern of the grade 3 AK may be similar to cutaneous carcinomas presenting with more scales. Therefore, grade 3 AK may be require more investigation such as biopsy and wide excision for definitive histopathological diagnosis. References 1 Rossi R, Mori M, Lotti T. Actinic keratosis. Int J Dermatol 2007; 46: 895-904. 2 Zalaudek I, Ferrara G, Leinweber B, Mercogliano A, D'Ambrosio A, Argenziano G. Pitfalls in the clinical and dermoscopic diagnosis of pigmented actinic keratosis. J Am Acad Dermatol 2005; 53: 1071-1074. 3 Zalaudek I, Giacomel J, Argenziano G et al. Dermoscopy of facial nonpigmented actinic keratosis. Br J Dermatol 2006; 155: 951-956. 4 Zalaudek I, Giacomel J, Schmid K et al. Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: a progression model. J Am Acad Dermatol 2012; 66: 589-597. 5 Pock L, Drlik L, Hercogova J. Dermatoscopy of pigmented actinic keratosis-a striking similarity to lentigo maligna. Int J Dermatol 2007; 46: 414-416. 6 Cuellar F, Vilalta A, Puig S, Palou J, Salerni G, Malvehy J. New dermoscopic pattern in actinic keratosis and related conditions. Arch Dermatol 2009; 145: 732. 7 Stolz W, Schiffner R, Burgdorf WH. Dermatoscopy for facial pigmented skin lesions.