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Original research
Actinic keratoses contiguous with squamous cell carcinomas are mostly non-hyperkeratotic and with severe dysplasia
  1. Ida M Heerfordt1,
  2. Thomas Poulsen2,
  3. Hans Christian Wulf1
  1. 1 Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
  2. 2 Department of Pathology, Hospital of Southern Jutland, Soenderborg, Denmark
  1. Correspondence to Dr Ida M Heerfordt, Department of Dermatology, Bispebjerg Hospital, Copenhagen 2400, Denmark; ida.marie.heerfordt{at}regionh.dk

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.

  • skin
  • skin neoplasms
  • skin diseases

Data availability statement

All data relevant to the study are included in the article.

https://doi.org/10.1136/jclinpath-2021-207497

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    Data availability statement

    All data relevant to the study are included in the article.

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    Footnotes

    • Handling editor Runjan Chetty.

    • Contributors Study concept and design: all authors. Acquisition, analysis and interpretation of data: all authors. Drafting of the manuscript: IMH. Critical revision of the manuscript for important intellectual content: all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.