Assessing the Concordance of Actinic Keratosis Counts on Digital Photographs with Clinical Examination in Organ Transplant Recipients.

Actinic keratoses (AKs) are common lesions that are usually diagnosed clinically. We sought to examine the accuracy of AK counts on digital photographs when compared with clinical examination counts. Skin sites of renal transplant recipients were examined clinically and on digital photographs by independent dermatologically-trained examiners. Specificity, sensitivity and Kendall's tau-b correlation coefficient were calculated based on exact photographic AK counts as well as counts with ± 1 AK tolerance. When 138 skin sites with 305 clinical AK counts were examined for total count ± 1 AK, the sensitivity and specificity of photography was 95% and 100%, respectively. There was significant positive correlation between AK counts on photographs and clinical examination (Ƭb = 0.537) and correlation was even higher for total count ± 1 AK (Ƭb = 0.758). The results show moderate to strong concordance between AK counts on digital photographs and on clinical examination.