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J Am Acad Dermatol. 2012 Apr;66(4):589-97. doi: 10.1016/j.jaad.2011.02.011. Epub 2011 Aug 11.

Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: a progression model.

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  • 1Department of Dermatology, Medical University of Graz, Graz, Austria. iris.zalaudek@gmail.com

Abstract

BACKGROUND:

Little is known about the dermoscopic features of keratinocyte skin cancer.

OBJECTIVE:

We sought to determine the dermoscopic features of facial actinic keratosis (AK), intraepidermal carcinoma (IEC), moderately to poorly differentiated invasive squamous cell carcinoma (SCC), and well-differentiated SCC of the keratoacanthoma type.

METHODS:

This was a retrospective analysis of dermoscopic images of histopathologically diagnosed keratinocyte skin cancer.

RESULTS:

A total of 243 (70 AK, 71 IEC, 78 SCC, and 24 keratoacanthomas) tumors of the face from 243 patients (mean age: 71.1 years; range: 44-94 years) were analyzed. The majority of patients had a fair skin type, history of melanoma or nonmelanoma skin cancer, and multiple AK. A red pseudonetwork was significantly associated with AK (P < .001), whereas dotted/glomerular vessels, diffuse yellow opaque scales, and microerosions were significantly more prevalent among IEC (P < .001). Hairpin vessels, linear-irregular vessels, targetoid hair follicles, white structureless areas, a central mass of keratin, and ulceration were significantly associated with invasive SCC (P < .001 for all criteria). Similar patterns as in SCC were observed among keratoacanthomas.

LIMITATIONS:

The retrospective design of our study and the lack of assessment of sensitivity and specificity of the dermoscopic criteria are limitations.

CONCLUSIONS:

Based on our findings we propose a progression model of facial AK developing into IEC and invasive SCC.

Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

PMID:
21839538
[PubMed - indexed for MEDLINE]
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