Review

. 2023 Jun;88(6):1317-1325.

doi: 10.1016/j.jaad.2022.12.057. Epub 2023 Feb 24.

Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines

Rachel E Christensen¹, Dirk M Elston², Brandon Worley¹, McKenzie A Dirr¹, Noor Anvery¹, Bianca Y Kang¹, Soon Bahrami³, Robert T Brodell⁴, Lorenzo Cerroni⁵, Carly Elston⁶, Tammie Ferringer⁷, M Yadira Hurley⁸, Kyle Garton⁹, Joyce Siong See Lee¹⁰, Yeqiang Liu¹¹, John C Maize², Jennifer M McNiff¹², Ronald P Rapini¹³, Omar P Sangueza¹⁴, Christopher R Shea¹⁵, Cheng Zhou¹⁶, Murad Alam¹⁷

Affiliations

¹ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
² Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
³ Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky.
⁴ Departments of Dermatology and Pathology, University of Mississippi Medical Center, Jackson, Mississippi; Staff Physician, Sonny Montgomery Veterans Administration Hospital, Jackson, Mississippi.
⁵ Department of Dermatology, Research Unit of Dermatopathology, Medical University of Graz, Graz, Austria.
⁶ Department of Dermatology, University of Alabama, Birmingham, Alabama.
⁷ Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania; Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania.
⁸ Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Michigan.
⁹ Division of Dermatology, Department of Medicine, University of Washington, Seattle, Washington.
¹⁰ National Skin Centre, Singapore.
¹¹ Department of Pathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
¹² Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
¹³ Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas.
¹⁴ Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
¹⁵ Section of Dermatology, Department of Medicine, University of Chicago, Chicago, Illinois.
¹⁶ Department of Dermatology, Peking University People's Hospital, Beijing, China.
¹⁷ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: m-alam@northwestern.edu.

PMID: 36841336
DOI: 10.1016/j.jaad.2022.12.057

Review

Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines

Rachel E Christensen et al. J Am Acad Dermatol. 2023 Jun.

. 2023 Jun;88(6):1317-1325.

doi: 10.1016/j.jaad.2022.12.057. Epub 2023 Feb 24.

Authors

Affiliations

¹ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
² Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
³ Division of Dermatology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky.
⁴ Departments of Dermatology and Pathology, University of Mississippi Medical Center, Jackson, Mississippi; Staff Physician, Sonny Montgomery Veterans Administration Hospital, Jackson, Mississippi.
⁵ Department of Dermatology, Research Unit of Dermatopathology, Medical University of Graz, Graz, Austria.
⁶ Department of Dermatology, University of Alabama, Birmingham, Alabama.
⁷ Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania; Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania.
⁸ Department of Dermatology, Saint Louis University School of Medicine, St. Louis, Michigan.
⁹ Division of Dermatology, Department of Medicine, University of Washington, Seattle, Washington.
¹⁰ National Skin Centre, Singapore.
¹¹ Department of Pathology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
¹² Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
¹³ Department of Dermatology, University of Texas McGovern Medical School at Houston, Houston, Texas.
¹⁴ Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
¹⁵ Section of Dermatology, Department of Medicine, University of Chicago, Chicago, Illinois.
¹⁶ Department of Dermatology, Peking University People's Hospital, Beijing, China.
¹⁷ Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: m-alam@northwestern.edu.

PMID: 36841336
DOI: 10.1016/j.jaad.2022.12.057

Abstract

Background: There is considerable variation in the literature regarding the dermatopathologic diagnostic features of and reporting guidelines for actinic keratosis (AK) and cutaneous squamous cell carcinoma (cSCC).

Objective: To develop consensus recommendations regarding diagnostic criteria, nomenclature, and reporting of AK and cSCC.

Methods: Literature review and cross-sectional multiround Delphi process including an international group of expert dermatopathologists followed by a consensus meeting.

Results: Consensus was achieved regarding the key dermatopathologic features necessary for diagnosing cSCC, AK, and associated variants; grading of degree of cellular differentiation in cSCC; utility of immunohistochemistry for diagnosis of cSCC; and pathologic features that should be reported for cSCC and AK.

Limitations: Consensus was not achieved on all questions considered.

Conclusion: Despite the lack of clarity in the literature, there is consensus among expert dermatopathologists regarding diagnostic criteria and appropriate reporting of AK and cSCC. Widespread implementation of these consensus recommendations may improve communication between dermatopathologists and clinicians, facilitating appropriate treatment of AK and cSCC.

Keywords: actinic keratosis; consensus; diagnosis; immunohistochemistry; international; pathology; squamous cell carcinoma.

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Conflict of interest statement

Conflicts of interest None disclosed.

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Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines

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Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: Consensus criteria and proposed reporting guidelines

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