Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines - 01/06/23

Doi : 10.1016/j.jaad.2022.12.057

Rachel E. Christensen, BS ^a, Dirk M. Elston, MD ^b, Brandon Worley, MD, MSc ^a, McKenzie A. Dirr, BA, BS ^a, Noor Anvery, BA ^a, Bianca Y. Kang, MD ^a, Soon Bahrami, MD ^c, Robert T. Brodell, MD ^d,^e, Lorenzo Cerroni, MD ^f, Carly Elston, MD ^g, Tammie Ferringer, MD ^h,ⁱ, M. Yadira Hurley, MD ^j, Kyle Garton, MD, PhD ^k, Joyce Siong See Lee, MBBS, MRCP ^l, Yeqiang Liu, PhD ^m, John C. Maize, MD ^b, Jennifer M. McNiff, MD ^n,^o, Ronald P. Rapini, MD ^p, Omar P. Sangueza, MD ^q,^r, Christopher R. Shea, MD ^s, Cheng Zhou, MD ^t, Murad Alam, MD, MSCI, MBA ^a,^u,^v,^⁎
^a Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^b Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina
^c Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
^d Departments of Dermatology and Pathology, University of Mississippi Medical Center, Jackson, Mississippi
^e Staff Physician, Sonny Montgomery Veterans Administration Hospital, Jackson, Mississippi
^f Department of Dermatology, Research Unit of Dermatopathology, Medical University of Graz, Graz, Austria
^g Department of Dermatology, University of Alabama, Birmingham, Alabama
^h Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania
ⁱ Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania
^j Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Michigan
^k Division of Dermatology, Department of Medicine, University of Washington, Seattle, Washington
^l National Skin Centre, Singapore
^m Department of Pathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
ⁿ Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
^o Department of Pathology, Yale School of Medicine, New Haven, Connecticut
^p Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas
^q Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina
^r Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
^s Section of Dermatology, Department of Medicine, University of Chicago, Chicago, Illinois
^t Department of Dermatology, Peking University People's Hospital, Beijing, China
^u Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
^v Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois

^∗Reprint requests: Murad Alam, MD, MSCI, MBA, Department of Dermatology, Northwestern University, 676 N St Clair St, Ste 1600, Chicago, IL 60611.Department of DermatologyNorthwestern University676 N St Clair StSte 1600ChicagoIL60611

Abstract

Background

There is considerable variation in the literature regarding the dermatopathologic diagnostic features of and reporting guidelines for actinic keratosis (AK) and cutaneous squamous cell carcinoma (cSCC).

Objective

To develop consensus recommendations regarding diagnostic criteria, nomenclature, and reporting of AK and cSCC.

Methods

Literature review and cross-sectional multiround Delphi process including an international group of expert dermatopathologists followed by a consensus meeting.

Results

Consensus was achieved regarding the key dermatopathologic features necessary for diagnosing cSCC, AK, and associated variants; grading of degree of cellular differentiation in cSCC; utility of immunohistochemistry for diagnosis of cSCC; and pathologic features that should be reported for cSCC and AK.

Limitations

Consensus was not achieved on all questions considered.

Conclusion

Despite the lack of clarity in the literature, there is consensus among expert dermatopathologists regarding diagnostic criteria and appropriate reporting of AK and cSCC. Widespread implementation of these consensus recommendations may improve communication between dermatopathologists and clinicians, facilitating appropriate treatment of AK and cSCC.

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Key words : actinic keratosis, consensus, diagnosis, immunohistochemistry, international, pathology, squamous cell carcinoma

Abbreviations used : AK, cSCC, SCC

Plan

Pathologic differentiation

Perineural invasion

Immunohistochemistry

Reporting of pathologic findings

Discussion

Conclusion

	Funding sources: None.
	IRB approval status: Not applicable.

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Vol 88 - N° 6

P. 1317-1325 - juin 2023 Retour au numéro

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Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines - 01/06/23

Abstract

Background

Objective

Methods

Results

Limitations

Conclusion

Plan

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