Abstract: Dai Hui, Jiang Hongyan, Xu Ai′e Department of Dermatology, Hangzhou Third People′s Hospital, Hangzhou 310009, China Corresponding author: Xu Ai′e, Email: xuaiehz@msn.com 【Abstract】 Objective To evaluate imaging features of verruca plana by dermoscopy and reflectance confocal microscopy （RCM）. Methods Totally, 88 untreated patients with verruca plana were enrolled into this study. One typical skin lesion was chosen from each patient and subjected to dermoscopy and RCM separately, and imaging features were recorded and analyzed. Results Dermoscopy revealed a light red background in 48 cases （54.55%）, a light yellow background in 40 cases （45.45%）, and a various number of punctate hemorrhages in 84 cases （95.45%）. RCM showed concentric onion?skin?like structures in 48 patients （54.55%）. Among 57 patients with disease duration > 1 year, 44 （77.19%） had the concentric onion?skin?like pattern, while only 4 （12.90%） patients had similar structures among 31 patients with disease duration < 1 year. A significant difference in the prevalence of concentric onion?skin?like structures was observed between patients with disease duration > 1 year and those with disease duration < 1 year （χ2 = 33.47, P < 0.05）. Of 88 patients, 86 （97.73%） had hyperpigmentation in the basal layer at the dermo?epidermal junction, intact dermal papillary rings, vasodilatation, hyperemia and 1 - 2 dilated capillaries in the dermal papillae. Eight patients were treated for 2 weeks, and the above features disappeared after the treatment under dermoscopy and RCM. Conclusion Based on clinical manifestations, dermoscopy and RCM features may be helpful for the diagnosis of verruca plana.