Actinic Keratosis Color and Its Associations: A Retrospective Photographic, Dermoscopic, and Histologic Evaluation.


Journal

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
ISSN: 1524-4725
Titre abrégé: Dermatol Surg
Pays: United States
ID NLM: 9504371

Informations de publication

Date de publication:
01 Jan 2022
Historique:
pubmed: 24 11 2021
medline: 6 1 2022
entrez: 23 11 2021
Statut: ppublish

Résumé

Actinic keratoses (AKs) have been described with varying color and morphology; however, no reports have demonstrated associations between color, vasculature, and inflammation. In this retrospective study, we analyze the clinical, dermoscopic, and histopathologic features of AKs to elucidate this relationship. A retrospective search for patients diagnosed with AK between January 2018 and October 2019 was performed. Clinical and dermoscopic photographs and pathology slides for all included subjects were reviewed. Forty-nine images and histopathology slides were analyzed. Dermoscopy of white AKs demonstrated scale and absence of erythema with corresponding absence of inflammation on histopathology. Dermoscopy of brown AKs revealed pseudonetwork, absent scale, and a variable vessel pattern with pigment incontinence and absence of inflammation on histopathology. Red AKs had a distinct polymorphous vessel pattern and presence of erythema on dermoscopy. On histopathology, about half of samples showed increased vascularity and variable inflammation. Pink AK dermoscopy revealed a presence of erythema with corresponding presence of inflammation on histopathology. This report adds to our understanding of AKs and confirms that, in general, the pinker or redder the AK, the more prominent the inflammatory infiltrate and vasculature, respectively. Dermatologists should continue to use their diagnostic skills to successfully diagnose and triage AKs.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Actinic keratoses (AKs) have been described with varying color and morphology; however, no reports have demonstrated associations between color, vasculature, and inflammation. In this retrospective study, we analyze the clinical, dermoscopic, and histopathologic features of AKs to elucidate this relationship.
METHODS METHODS
A retrospective search for patients diagnosed with AK between January 2018 and October 2019 was performed. Clinical and dermoscopic photographs and pathology slides for all included subjects were reviewed.
RESULTS RESULTS
Forty-nine images and histopathology slides were analyzed. Dermoscopy of white AKs demonstrated scale and absence of erythema with corresponding absence of inflammation on histopathology. Dermoscopy of brown AKs revealed pseudonetwork, absent scale, and a variable vessel pattern with pigment incontinence and absence of inflammation on histopathology. Red AKs had a distinct polymorphous vessel pattern and presence of erythema on dermoscopy. On histopathology, about half of samples showed increased vascularity and variable inflammation. Pink AK dermoscopy revealed a presence of erythema with corresponding presence of inflammation on histopathology.
CONCLUSION CONCLUSIONS
This report adds to our understanding of AKs and confirms that, in general, the pinker or redder the AK, the more prominent the inflammatory infiltrate and vasculature, respectively. Dermatologists should continue to use their diagnostic skills to successfully diagnose and triage AKs.

Identifiants

pubmed: 34812188
doi: 10.1097/DSS.0000000000003281
pii: 00042728-202201000-00014
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

57-60

Informations de copyright

Copyright © 2021 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

Références

Chuang TY, Brashear R. Risk factors of non-melanoma skin cancer in United States veterans patients: a pilot study and review of literature. J Eur Acad Dermatol Venereol 1999;12:126–32.
Criscione VD, Weinstock MA, Naylor MF, Luque C, et al. Actinic keratoses: natural history and risk of malignant transformation in the veterans affairs topical tretinoin chemoprevention trial. Cancer 2009;115:2523–30.
De Almeida CM, de Jesus SF, de Oliveira Poswar F, Gomes ES, et al. Increasing demonstration of angiogenic markers in skin neoplastic lesions. Pathol Res Pract 2016;212:101–5.
Themstrup L, Pellacani G, Welzel J, Holmes J, et al. In vivo microvascular imaging of cutaneous actinic keratosis, Bowen's disease and squamous cell carcinoma using dynamic optical coherence tomography. J Eur Acad Dermatol Venereol 2017;31:1655–62.
Strieth S, Hartschuh W, Pilz L, Fusenig NE. Angiogenic switch occurs late in squamous cell carcinomas of human skin. Br J Cancer 2000;82:591–600.

Auteurs

Jessica G Labadie (JG)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Elsy Compres (E)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Joel C Sunshine (JC)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Dermatopathology, Northwestern University, Chicago, Illinois.

Murad Alam (M)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Pedram Gerami (P)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Dermatopathology, Northwestern University, Chicago, Illinois.

Vishnu Harikumar (V)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Emily Poon (E)

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Kenneth A Arndt (KA)

SkinCare Physicians, Chestnut Hill, Massachusetts.
Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Jeffrey S Dover (JS)

SkinCare Physicians, Chestnut Hill, Massachusetts.
Yale University School of Medicine, New Haven, Connecticut.
Warren Alpert Medical School of Brown University, Providence, Rhode Island.

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