TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Background: Actinic keratosis (AK) is a common premalignant skin lesion that develops on chronically sun-exposed areas, particularly in elderly individuals. Due to overlapping clinical features, AK may be misdiagnosed as inflammatory dermatoses, including psoriasis.

Aim: To highlight the potential for misdiagnosis of scalp actinic keratosis as psoriasis and to emphasize the diagnostic value of dermoscopy and histopathology.

Methods: A 79-year-old man with persistent scalp lesions previously diagnosed as psoriasis was clinically evaluated. Dermoscopic examination was performed, followed by histopathological assessment of a skin biopsy.

Results: The patient showed no significant improvement after one year of topical corticosteroid therapy. Dermoscopic findings suggested actinic keratosis, which was subsequently confirmed by histopathology. No evidence of psoriasis was identified.

Conclusions: Diagnostic reassessment is essential in persistent scalp lesions. Dermoscopy and histopathological examination are valuable tools for accurate diagnosis and timely management of actinic keratosis. 

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