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Assessment of syndecan-1 (CD138) and Ki-67 expression for differentiating keratoacanthoma and squamous cell carcinoma
Lorena Lammoglia-Ordiales1, Sonia Toussaint-Caire, Martha Contreras-Barrera
1Dermatology Department, Hospital General Dr Manuel Gea González, Mexico City, Mexico. dra.lammoglia@gmail.com
Background:
There is a major controversy over the natural behavior of keratoacanthoma (KA). KAs have been described as benign lesions, but also as variants of squamous cell carcinoma (SCC). Microscopic differentiation between these 2 entities is problematic, and sometimes impossible. Syndecan-1 (CD138) is an adhesion molecule whose expression appears to be inversely correlated with tumor invasiveness. Elevated Ki-67 expression is indicative of a high proliferation index, a feature of malignant tumors.
Methods:
Syndecan-1 and Ki-67 expression were assessed in 22 KA skin samples and in 17 SCC skin biopsies.
Results:
Syndecan-1 expression was diminished in the SCC specimens compared with the KA specimens ( P =.000). Ki-67 expression was increased in the SCC specimens compared with the KA specimens, with mean values of 9 and 0.08, respectively ( P =.000).
Limitations:
Further studies that compare intermediate risk KAs to typical KAs and SCCs are required to corroborate these findings.
Conclusion:
The assessment of syndecan-1 and Ki-67 expression in skin biopsies is a helpful tool for differentiating KA and SCC