Reflectance confocal microscopy criteria for squamous cell carcinomas and actinic keratoses Journal Article
| Authors: | Rishpon, A.; Kim, N.; Scope, A.; Porges, L.; Oliviero, M. C.; Braun, R. P.; Marghoob, A. A.; Fox, C. A.; Rabinovitz, H. S. |
| Article Title: | Reflectance confocal microscopy criteria for squamous cell carcinomas and actinic keratoses |
| Abstract: | Objective: To identify criteria for the diagnosis of squamous cell carcinoma (SCC) and actinic keratosis (AK) by in vivo reflectance confocal microscopy (RCM). Design: Prospective RCM imaging of lesions suspected clinically and/or dermoscopically to be SCC or AK, followed by RCM assessment of the biopsy-proven SCCs and AKs. Setting: Private skin cancer clinic, Plantation, Florida. Patients: A total of 38 lesions in 24 patients were assessed, including 7 AKs, 25 SCCs in situ, 3 invasive SCCs, and 3 keratoacanthomas. Interventions: Prior to undergoing biopsy, all lesions were assessed by RCM. Results: Mosaic RCM images at the stratum corneum level revealed scale in 29 SCCs (95%) and in all 7 AKs. Polygonal nucleated cells at the stratum corneum were seen in 3 SCCs (10%) and 1 AK (14%). All 38 cases displayed an atypical honeycomb and/or a disarranged pattern of the spinous-granular layer of the epidermis; round nucleated cells were seen in the spinous-granular layer in 20 SCCs (65%) and 1AK(14%). Round blood vessels in the superficial dermis were seen in 28 SCCs (90%) and 5 AKs (72%). Conclusions: An increasing frequency of abnormal RCM features can be observed across the spectrum of keratinocytic neoplasias. The presence of an atypical honeycomb or a disarranged pattern of the spinous-granular layer, round nucleated cells at the spinous-granular layer, and round blood vessels traversing through the dermal papilla are the key RCM features of SCC. ©2009 American Medical Association. All rights reserved. |
| Keywords: | adult; clinical article; aged; aged, 80 and over; middle aged; clinical feature; squamous cell carcinoma; carcinoma, squamous cell; prospective studies; actinic keratosis; confocal microscopy; microscopy, confocal; skin neoplasms; tumor biopsy; in vivo study; keratosis, actinic; blood vessel; keratoacanthoma; stratum corneum |
| Journal Title: | Archives of Dermatology |
| Volume: | 145 |
| Issue: | 7 |
| ISSN: | 0003-987X |
| Publisher: | American Medical Association |
| Date Published: | 2009-07-01 |
| Start Page: | 766 |
| End Page: | 772 |
| Language: | English |
| DOI: | 10.1001/archdermatol.2009.134 |
| PUBMED: | 19620557 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: ARDEA" - "Source: Scopus" |
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