Thickness of Actinic Keratosis Does Not Predict Dysplasia Severity or P53 Expression.
The severity of dysplasia and expression of p53 in actinic keratosis (AK) is of importance for the transformation to squamous cell carcinoma. It is assumed that it is most important to treat thick AKs as they are believed to be more dysplastic than thin AKs. However, a relation between AK thickness and dysplasia or the expression of p53 has never been demonstrated. The aim of this study was to investigate this possible relation. Sixty-six AKs were included for clinical and histological examination. Prior to performing a punch biopsy, the clinical thickness of each AK was measured objectively using two scale bars with a thickness of 0.5 mm and 1 mm. Subsequently, the thickness of the epidermis, the severity of dysplasia and the expression of p53 were assessed histologically. We found a strong and significant positive correlation between measured clinical thickness of the AKs and the histological thickness of epidermis (p < 0.0001). However, the clinical thickness did not correlate with either the severity of dysplasia (p = 0.7) or the expression of p53 (p = 0.5). In conclusion, thin AKs show the same severity of dysplasia and expression of p53 as thicker AK lesions. Consequently, clinical thickness cannot predict aggressiveness.
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, DK-2400 NV Copenhagen, Denmark.
Ida M
IM
Heerfordt
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, DK-2400 NV Copenhagen, Denmark.
Christoffer V
CV
Nissen
Department of Pathology, Hospital of Southern Jutland, DK-6400 Soenderborg, Denmark.
Thomas
T
Poulsen
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, DK-2400 NV Copenhagen, Denmark.
Peter A
PA
Philipsen
Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, DK-2400 NV Copenhagen, Denmark.
Hans Christian
HC
Wulf
Br J Dermatol. 2006 Jul;155(1):9-22
16792746
Int J Cosmet Sci. 2003 Apr;25(1-2):45-53
18494882
Nature. 1991 Jun 6;351(6326):453-6
2046748
J Am Acad Dermatol. 2000 Jan;42(1 Pt 2):8-10
10607350
Semin Cutan Med Surg. 1999 Mar;18(1):3-14
10188837
Oncogene. 1991 Oct;6(10):1785-9
1717923
J Am Acad Dermatol. 1991 May;24(5 Pt 1):738-43
1869646
Am J Clin Dermatol. 2004;5(3):141-4
15186192
Cancer Epidemiol Biomarkers Prev. 2004 Dec;13(12):1996-2002
15598753
Br J Dermatol. 2012 Jun;166(6):1327-32
22250644
Neoplasia. 1999 Nov;1(5):468-75
10933063
J Am Acad Dermatol. 1999 Sep;41(3 Pt 1):443-8
10459120
Cochrane Database Syst Rev. 2012 Dec 12;12:CD004415
23235610
Br J Dermatol. 2007 Feb;156(2):222-30
17223860
J Eur Acad Dermatol Venereol. 2015 May;29(5):991-7
25428612
N Engl J Med. 2001 Mar 29;344(13):975-83
11274625
J Am Acad Dermatol. 1996 Aug;35(2 Pt 1):223-42
8708026
J Eur Acad Dermatol Venereol. 2015 Nov;29(11):2069-79
26370093
Proc Natl Acad Sci U S A. 1991 Nov 15;88(22):10124-8
1946433
J Eur Acad Dermatol Venereol. 2016 Aug;30(8):1303-7
26955898
Psychol Bull. 1968 Oct;70(4):213-20
19673146
J Am Acad Dermatol. 2013 Jan;68(1 Suppl 1):S28-38
23228304
J Clin Invest. 2012 Feb;122(2):464-72
22293185
J Am Acad Dermatol. 2000 Jan;42(1 Pt 2):11-7
10607351
Br J Dermatol. 2007 May;156 Suppl 3:8-12
17488400
Cancer. 1997 Mar 1;79(5):920-3
9041154
Br J Dermatol. 2009 May;160(5):1026-33
19183171