Pain evaluation in patients affected by cutaneous squamous cell carcinoma and actinic keratosis: an observational study.
BACKGROUND
Pain is a frequent symptom in cancer patients. The aim of our study was to evaluate the presence of pain in histopathologically-diagnosed hypertrophic actinic keratosis (AK) or cutaneous squamous cell carcinoma (SCC).


METHODS
An observational study evaluating pain presence and intensity in skin cancer was performed, including patients affected either by SCC or by hypertrophic AK. Pain intensity was assessed using the 11-point Numeric Rating Scale, ranging from 0 (absence of pain) to 10 (most intense pain). Both spontaneous pain and pressure-related pain intensity, due to local digital pressure, were evaluated.


RESULTS
In patients with SCC, spontaneous pain was present in 57.5% of the cases, while pressure-related pain was revealed in 80.0% of the cases. In hypertrophic AK patients, spontaneous pain was detected only in 15.0% of the cases, while pressure-related pain was present in 25.0% of the cases. A statistically significant difference between the 2 groups was found in the evaluation of spontaneous and pressure-related pain values, these values being significantly higher in the SCC group. No significant correlations between the degree of inflammation, the histotype or invasiveness of SCCs, and the intensity of pain were found.


CONCLUSIONS
The recognition of pain as a symptom, more frequently associated with SCC, might prove useful in the clinical practice. Further research is needed, in order to better understand and characterize pain associated with different skin neoplasms.
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Emi
E
Dika
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Sabina
S
Vaccari
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Pier A
PA
Fanti
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Bianca M
BM
Piraccini
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy - alessiabarisani@gmail.com.
Alessia
A
Barisani
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Carlotta
C
Baraldi
Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Annalisa
A
Patrizi
D000368:Aged; D000369:Aged, 80 and over; D000072716:Cancer Pain / Q000175:diagnosis* / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D055623:Keratosis, Actinic / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D012878:Skin Neoplasms / Q000150:complications* / Q000473:pathology