评估用于早期检测光化性角化病基础上发生的鳞状细胞癌的皮肤镜标准。
Evaluation of dermatoscopic criteria for early detection of squamous cell carcinoma arising on an actinic keratosis.
作者信息
Papageorgiou Chryssoula, Lallas Aimilios, Manoli Sofia Magdalini, Longo Caterina, Lai Michela, Liopyris Konstantinos, Lallas Konstantinos, Lazaridou Elizabeth, Apalla Zoe
机构信息
Second Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
First Dermatology Department, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
J Am Acad Dermatol. 2022 Apr;86(4):791-796. doi: 10.1016/j.jaad.2021.03.111. Epub 2021 Apr 20.
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.
背景
基于临床和皮肤镜特征，晚期鳞状细胞癌（SCC）可轻易与光化性角化病（AK）相鉴别。然而，在真皮浸润的初始阶段，SCC在临床上可能仍表现为扁平状，即便增加皮肤镜检查，将其与AK区分开来仍具有挑战性。
目的
本研究旨在探究能够提示早期浸润并可作为鉴别早期SCC与AK的有力预测指标的临床和皮肤镜标准。
方法
3名独立研究人员对组织病理学诊断的AK和早期SCC的临床及皮肤镜图像进行评估，以确定是否存在预定义标准。
结果
共纳入50例早期SCC和45例AK。早期SCC主要的皮肤镜阳性预测指标为点状/肾小球样血管（优势比[OR] 3.83）、发夹样血管（OR 12.12）和白色无结构区域（OR 3.58），而背景红斑是SCC的阴性预测指标（OR 0.22）。
局限性
图像的回顾性评估。此外，本研究中的鉴别诊断仅限于AK和早期SCC之间。
结论
我们确定了鉴别AK和早期SCC的有力预测指标，这可能会在日常临床实践中更好地指导管理决策。
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