Expression of cytokeratin subtypes in intraepidermal malignancies: a guide for differentiation.
BACKGROUND
Among intraepidermal malignancies of epithelial origin, Bowen's disease, bowenoid actinic keratosis (BAK), intraepidermal malignant eccrine poroma (MEP), and Paget's disease may pose diagnostic difficulties.


METHODS
Histologic features and immunohistochemical profiles of 24 cases of Bowen's disease, 21 cases of BAK, 18 cases of intraepidermal MEP, and 11 cases of Paget's disease were analyzed.


RESULTS
Using multivariate logistic regression test, multinuclear giant cells and solar degeneration were found to be the only histologic parameters of diagnostic help. On the other hand, a widespread positive reaction for CK 5/8, CK 7, CK 19, and negative reaction for CK 10, was a helpful feature in the differentiation of Paget's disease from Bowen's disease and BAK. The widespread and strong expression of CK 10 was seen in almost all cases of Bowen's disease in contrast to BAK. The widespread expression of CK 5/8 and CK 7, and negative reaction for CK 10, was in favor of Paget's disease, compared to intraepidermal MEP. On the other hand, widespread expression of CK 19 was a common finding in intraepidermal MEP, in contrast to Bowen's disease.


CONCLUSIONS
An immunohistochemical panel may provide significant hints on the differentiation of common intraepidermal malignancies, especially in problematic cases.
Aslan
Figen
F
Department of Pathology, Cerrahpasa Medical Faculty, University of Istanbul, Cerrahpasa, Istanbul, Turkey. cdemirkesen@yahoo.com
Demirkesen
Cuyan
C
Cağatay
Penbe
P
Tüzüner
Nükhet
N
D001913:Bowen's Disease / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007633:Keratins / Q000032:analysis*; D007642:Keratosis / Q000175:diagnosis / Q000473:pathology; D009375:Neoplasms, Glandular and Epithelial / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology*; D010145:Paget Disease, Extramammary / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology; D010144:Paget's Disease, Mammary / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology; D012044:Regression Analysis; D012878:Skin Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology*; D013544:Sweat Gland Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology
D007633:Keratins