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. 2025 Jun 10;17(12):1923.
doi: 10.3390/cancers17121923.

Clinico-Pathologic Profile of a Cohort of Patients with Actinic Keratosis in a Tertiary Center in Romania

Cristina Soare  1 , Elena Codruța Cozma  2 , Andrei Ludovic Poroșnicu  3   4 , Daniel Alin Cristian  5   6 , Draga Maria Mandi  6 , Călin Giurcăneanu  1   2 , Vlad Mihai Voiculescu  1   2
Affiliations

Clinico-Pathologic Profile of a Cohort of Patients with Actinic Keratosis in a Tertiary Center in Romania

Cristina Soare et al. Cancers (Basel). .

Abstract

Background/objectives: Actinic keratosis (AK) is considered to be the most common form of in situ carcinoma and typically arises on skin that has been chronically exposed to ultraviolet radiation. The need for early diagnosis, using non-invasive methods, has allowed for a non-surgical approach to these conditions with a significant impact on the quality of life of patients.

Methods: A retrospective study was conducted on 58 patients diagnosed with AK who underwent surgical excision at a tertiary center in Bucharest, Romania between 2018 and 2023. Clinical parameters (age, sex, lesion size, anatomical location, comorbidities) and histopathological variables (AK subtype, KIN grade, pleomorphism, solar elastosis, inflammatory infiltrate) were analyzed. Statistical associations between histological findings and clinical features were assessed using Fisher's exact test.

Conclusions: The study confirmed a predominance of AK among elderly patients, with hypertrophic lesions and moderate dysplasia (KIN II) being most common. Higher KIN grades correlated significantly with more severe pleomorphism, solar elastosis, and inflammatory response, suggesting progressive UV-induced skin damage. The findings underscore the importance of clinicopathological correlation for risk stratification and support the integration of non-invasive diagnostic tools to improve early detection and management of AK.

Keywords: actinic keratosis; epidemiology; histological subtypes; squamous cell carcinoma.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Histopathological grading of AKs (KIN I–III). Color coding: brown—normal keratinocytes, red—dysplastic keratinocytes in AK lesion. Image created in CanvaPro (https://www.canva.com/pro/, accessed on 1 May 2025).
Figure 2
Figure 2
CONSORT diagram representing the selection process of the cases included in the study.
Figure 3
Figure 3
Histopathological aspects of (a) KIN I–II and (b) KIN III AKs. Magnification ×100; hematoxylin–eosin stain.
Figure 4
Figure 4
Histopathological aspects of (a) KIN II–III and (b) KIN III AKs. Magnification ×200; hematoxylin–eosin stain.
See this image and copyright information in PMC

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