Correlations between histopathologic and dermoscopic findings in Korean actinic keratosis

Abstract

Skin biopsy for AK diagnosis is usually performed on only a limited part of the whole lesion. Therefore, a clinical diagnosis is important. According to a study, there is no significant correlation between histopathological and clinical classification system. We examined the correlation between microscopic information and dermoscopic findings to deduce if dermoscopic information reflects histopathologic grade severity. Forty seven patients with histologically confirmed AK were enrolled and positive ratio of red pseudonetwork, rosette, red background and targetoid signs, white-to-yellow scale, white structureless area, and pigmentation from dermoscopic findings were investigated. Furthermore, viable epidermal thickness, vessel lumen dimensions, existence and thickness of ortho- and parakeratosis, degree of sola elastosis, flag sign existence, and Roewert-Huber classification were measured as histologic findings. Red background did not show a significant correlation with vascular dimension or viable epidermal thickness. When targetoid sign was present, vascular dimension was significantly larger but showed no correlation with viable epidermal thickness, parakeratosis or orthokeratosis. Solar elastosis level was significantly higher when white-to-yellow scale was present. According to Spearman's correlation analysis, ortho/parakeratotic thickness showed correlations with each other. The negative correlation between viable epidermal thickness and vascular dimension was also shown. Roewert-Huber histologic AK classification showed no correlation with any factors we checked. Factors considered to be characteristic features of AK in dermoscopy seemed unassociated with histologic AK classification and additional research is needed to determine degree of dysplasia of AK lesions using dermoscopy.

Assessment of 5‐Aminolaevulinic Acid Photodynamic Therapy (ALA‐PDT) in Chinese patients with actinic keratosis: Correlation of dermoscopic features with histopathology

“…17 A more recent study indicated that there were no significant correlations between dermoscopic findings and histological AK classification. 18 In contrast to these studies, our analysis demonstrated the significant correlation between dermoscopic and AK gradings. Furthermore, some dermoscopic characteristics were associated with histopathological features.…”

“…Schmitz et al demonstrated the lack of correlation between Olsen clinical classification and Roewert‐Huber histological classification in 892 actinic keratoses, suggesting it was not possible to draw conclusions about the histopathology of AK lesions from their clinical appearance 17 . A more recent study indicated that there were no significant correlations between dermoscopic findings and histological AK classification 18 . In contrast to these studies, our analysis demonstrated the significant correlation between dermoscopic and AK gradings.…”

Dermatoscopy of Facial Non-Pigmented Actinic Keratosis and Intraepidermal Carcinoma

“…In this form, the lesion has an atrophic epidermis on histopathology [5]. According to one study, atrophic type AK more commonly presents with red pseudonetwork [37].…”

“…Skilled observers can predict the histologic grade of AK with dermatoscopy, although in consensus with clinical features some studies do not find such correlations [37,38]. The following dermatoscopic-histopathologic correlations have been previously proposed:…”

Diagnostic Accuracy of Dermoscopy of Actinic Keratosis: A Systematic Review

“…Actinic keratosis (AK) is a cutaneous neoplasm that arises on chronically sun-exposed skin. For years, AK was considered to be a separate entity from squamous cell carcinoma (SCC) [1], a premalignant lesion; however, in recent years this concept has been challenged, and now most authors consider AK the continuum of SCC [2][3][4]. The rate of progression to SCC differs greatly among the studies, ranging from 0.025%-20% per year [5,6]; however, it has been doc-umented that 60%-80% of SCCs arise from AK.…”