Evaluation of dermatoscopic criteria for early detection of squamous cell carcinoma arising on an actinic keratosis - 26/04/21

Doi : 10.1016/j.jaad.2021.03.111

Chryssoula Papageorgiou, MD ^a,^⁎ , Aimilios Lallas, PhD ^b, Sofia Magdalini Manoli, MD ^b, Caterina Longo, PhD ^c,^d, Michela Lai, MD ^c,^d, Konstantinos Liopyris, PhD ^e, Konstantinos Lallas, MD ^b, Elizabeth Lazaridou, PhD ^a, Zoe Apalla, PhD ^a
^a Second Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
^b First Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
^c Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale–IRCCS di Reggio, Reggio Emilia, Italy
^d Department of Dermatology, University of Modena e Reggio Emilia, Modena, Italy
^e First Department of Dermatology, University of Athens, Andreas Sygros Hospital of Skin and Venereal Diseases, Athens, Greece

^∗Correspondence to: Chryssoula Papageorgiou, MD, Second Dermatology Department, Aristotle University, 76 Agiou Pavlou, Pavlos Melas, 564 29, Thessaloniki, Greece.Second Dermatology DepartmentAristotle University76 Agiou Pavlou, Pavlos MelasThessaloniki564 29Greece

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Abstract

Background

Advanced squamous cell carcinoma (SCC) can be discriminated easily from actinic keratosis (AK) based on clinical and dermatoscopic features. However, at the initial stage of dermal invasion, SCC might still be clinically flat and discrimination from AK remains challenging, even with the addition of dermatoscopy.

Objective

The aim of this study was to investigate the clinical and dermatoscopic criteria that could suggest early invasion and serve as potent predictors to discriminate early SCC from AK.

Methods

Clinical and dermatoscopic images of histopathologically diagnosed AKs and early SCCs were evaluated for the presence of predefined criteria by 3 independent investigators.

Results

A total of 50 early SCCs and 45 AKs were included. The main positive dermatoscopic predictors of early SCC were dotted/glomerular vessels (odds ratio [OR] 3.83), hairpin vessels (OR 12.12), and white structureless areas (OR 3.58), whereas background erythema represented a negative SCC predictor (OR 0.22).

Limitations

The retrospective evaluation of images. Moreover, the differential diagnosis included in the study is restricted between AK and early SCC.

Conclusions

We identified potent predictors for the discrimination of AK and early SCC that may better guide management decisions in everyday clinical practice.

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Key words : actinic keratosis, dermatoscopy, dermoscopy, skin cancer, squamous cell carcinoma

Abbreviations used : AK, SCC

Plan

	Funding sources: None.
	IRB approval status: Waived, as the study protocol did not affect patient management.
	Reprints not available from the authors.

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Evaluation of dermatoscopic criteria for early detection of squamous cell carcinoma arising on an actinic keratosis - 26/04/21

Abstract

Background

Objective

Methods

Results

Limitations

Conclusions

Plan

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