Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: A progression model

作者：Zalaudek Iris^*; Giacomel Jason; Schmid Karin; Bondino Silvia; Rosendahl Cliff; Cavicchini Stefano; Tourlaki Athanasia; Gasparini Saturnino; Bourne Peter; Keir Jeff; Kittler Harald; Eibenschutz Laura; Catricala Caterina; Argenziano Giuseppe

来源：Journal of the American Academy of Dermatology, 2012, 66(4): 589-597.

DOI：10.1016/j.jaad.2011.02.011

• actinic keratosis
• dermatoscopy
• nonmelanoma skin cancer
• squamous cell carcinoma

Background: Little is known about the dermoscopic features of keratinocyte skin cancer. %26lt;br%26gt;Objective: We sought to determine the dermoscopic features of facial actinic keratosis (AK), intraepidermal carcinoma (IEC), moderately to poorly differentiated invasive squamous cell carcinoma (SCC), and well-differentiated SCC of the keratoacanthoma type. %26lt;br%26gt;Methods: This was a retrospective analysis of dermoscopic images of histopathologically diagnosed keratinocyte skin cancer. %26lt;br%26gt;Results: A total of 243 (70 AK, 71 IEC, 78 SCC, and 24 keratoacanthomas) tumors of the face from 243 patients (mean age: 71.1 years; range: 44-94 years) were analyzed. The majority of patients had a fair skin type, history of melanoma or nonmelanoma skin cancer, and multiple AK. A red pseudonetwork was significantly associated with AK (P %26lt; .001), whereas dotted/glomerular vessels, diffuse yellow opaque scales, and microerosions were significantly more prevalent among IEC (P %26lt; .001). Hairpin vessels, linear-irregular vessels, targetoid hair follicles, white structureless areas, a central mass of keratin, and ulceration were significantly associated with invasive SCC (P %26lt; .001 for all criteria). Similar patterns as in SCC were observed among keratoacanthomas. %26lt;br%26gt;Limitations: The retrospective design of our study and the lack of assessment of sensitivity and specificity of the dermoscopic criteria are limitations. %26lt;br%26gt;Conclusions: Based on our findings we propose a progression model of facial AK developing into IEC and invasive SCC. (J Am Acad Dermatol 2012;66:589-97.)

• 出版日期2012-4