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Actinic keratoses show variable histological basal growth patterns - a proposed classification adjustment
L Schmitz1, T Gambichler1, G Gupta2,3
1Department of Dermatology, Venereology and Allergology, Ruhr-University, Bochum, Germany.
Summary
Histological grading of actinic keratoses (AK) does not correlate with basal epidermal growth patterns. The study suggests incorporating both upward and downward growth patterns for a more comprehensive AK classification.
Area of Science:
- Dermatopathology
- Histology
- Oncology
Background:
- Current actinic keratosis (AK) histological classifications lack assessment of basal epidermal growth patterns.
- The clinical significance of basal epidermal growth patterns in AK remains understudied.
Purpose of the Study:
- To evaluate the extent of atypical keratinocytes throughout the epidermis in AK.
- To analyze variations in basal growth patterns of AK lesions.
Main Methods:
- Histological assessment of 246 AK lesions from routine practice, focusing on head/face locations.
- Determination of histological grade (AK I-III) and basal growth patterns (crowding, budding, papillary sprouting).
Main Results:
- No significant correlation was found between AK histological grade (I-III) and basal growth patterns (P = 0.4666).
- Adnexal structure involvement, infiltration, and increased vascularity were independent predictors for specific basal growth patterns (pro II and pro III).
Conclusions:
- Established AK histological grading (I-III) does not align with observed basal growth patterns (pro I-III).
- AK exhibits varying degrees of downward epidermal extension, in addition to upward growth.
- Future histological classifications of AK should integrate both upward and downward growth assessments for improved accuracy.
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