TY - JOUR
T1 - Reflectance confocal microscopy criteria for squamous cell carcinomas and actinic keratoses
AU - Rishpon, Ayelet
AU - Kim, Nancy
AU - Scope, Alon
AU - Porges, Leeor
AU - Oliviero, Margaret C.
AU - Braun, Ralph P.
AU - Marghoob, Ashfaq A.
AU - Fox, Christi Alessi
AU - Rabinovitz, Harold S.
PY - 2009/7
Y1 - 2009/7
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=67650838150&partnerID=8YFLogxK
U2 - 10.1001/archdermatol.2009.134
DO - 10.1001/archdermatol.2009.134
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C2 - 19620557
AN - SCOPUS:67650838150
SN - 0003-987X
VL - 145
SP - 766
EP - 772
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 7
ER -