Actinic keratoses contiguous with squamous cell carcinomas are mostly non-hyperkeratotic and with severe dysplasia

J Clin Pathol. 2022 Aug;75(8):560-563. doi: 10.1136/jclinpath-2021-207497. Epub 2021 Apr 16.

Abstract

Aims: Actinic keratosis (AK) is a precursor of cutaneous squamous cell carcinoma (SCC). No validated parameters can predict which AKs will progress into SCCs, but especially thick AKs are under suspicion. The clinical and histopathological thickness of AKs is strongly correlated. This study aimed to investigate the thicknesses and degree of dysplasia of AKs contiguous with SCCs assuming these AKs represent the AKs that have undergone malignant transformation.

Methods: Files of the Pathology Department, Hospital of Southern Jutland, Denmark, were reviewed. 111 cases met the inclusion criteria: a skin biopsy containing an invasive SCC. All SCCs merged with an AK at the edge. Degree of dysplasia, epidermal thickness and stratum corneum thicknesses of AKs were measured.

Results: All AKs showed severe dysplasia. Most AKs had a stratum corneum thickness under 0.1 mm and an epidermal thickness under 0.5 mm, corresponding to clinically thin and non-hyperkeratotic AKs.

Conclusions: Our result suggests malignant progression potential of AKs regardless of thickness.

Keywords: skin; skin diseases; skin neoplasms.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Humans
  • Hyperplasia
  • Keratosis, Actinic* / complications
  • Keratosis, Actinic* / pathology
  • Skin Neoplasms* / pathology