Fluorescence diagnosis in keratinocytic intraepidermal neoplasias.
BACKGROUND
As different tissue types have distinct capabilities to accumulate protoporphyrin-IX, fluorescence diagnosis with aminolevulinic acid-induced porphyrin (FDAP) could be used to discriminate between different tissue types.


OBJECTIVE
Protoporphyrin-IX accumulation and proliferation were studied in cutaneous squamous (pre)malignancies to see whether FDAP could be used to discriminate between different stages of keratinocytic intraepidermal neoplasia or proliferative status.


METHODS
FDAP was performed in 14 patients (86 lesions) and biopsy specimens were taken, on which (immuno)histochemistry was performed for histopathologic classification and assessment of Ki67-antigen expression. Stratum corneum thickness was also measured.


RESULTS
The fluorescence ratio (lesional:nonlesional skin) showed neither significant differences between the different keratinocytic intraepidermal neoplasia stages, nor between different levels of Ki67-antigen expression. Macroscopic fluorescence intensity and stratum corneum thickness were negatively correlated.


CONCLUSIONS
Relatively few malignancies were biopsied.


CONCLUSIONS
With FDAP we were not able to discriminate between keratinocytic intraepidermal neoplasia lesions or proliferative activity. However, hyperkeratosis appeared to be an important determinant in variations in macroscopic fluorescence intensity.
Department of Dermatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. t.smits@derma.umcn.nl
Tim
T
Smits
Marloes M
MM
Kleinpenning
Willeke A M
WA
Blokx
Peter C M
PC
van de Kerkhof
Piet E J
PE
van Erp
Marie-Jeanne P
MJ
Gerritsen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D049109:Cell Proliferation; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D004817:Epidermis / Q000473:pathology*; D005260:Female; D005453:Fluorescence; D006801:Humans; D007150:Immunohistochemistry; D015603:Keratinocytes / Q000473:pathology*; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017319:Photosensitizing Agents; D011524:Protoporphyrins; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology
D019394:Ki-67 Antigen; D017319:Photosensitizing Agents; D011524:Protoporphyrins; D000622:Aminolevulinic Acid; C028025:protoporphyrin IX