Incipient intraepidermal cutaneous squamous cell carcinoma

A proposal for reclassifying and grading solar (actinic) keratoses

V. A. Yantsos, N. Conrad, E. Zabawski, C. J. Cockerell

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Actinic keratoses (AKs) are primarily induced by ultraviolet (UV) radiation and are often identified as premalignant lesions. In our opinion, AKs are proliferations of transformed, neoplastic keratinocytes confined to the epidermis that may eventually extend into the dermis, at which point they are termed squamous cell carcinoma (SCC). In contrast to AKs, SCCs have the potential to metastasize and kill. This process is analogous to that of evolving carcinoma of the uterine cervix that has been termed cervical intraepithelial neoplasia (CIN), a time-tested and reliable classification that provides clinicians with accurate information on which to base treatment decisions regarding cervical neoplasms following biopsy testing. A similar classification scheme could provide guidance to clinicians for the diagnosis and treatment of evolving SCC of the skin and as such, we propose a similar classification using the terminology keratinocytic intraepidermal neoplasia (KIN). This system is more reflective of the histology and natural history of SCC and eliminates ambiguity in the terminology of lesions currently referred to as AKs. The KIN classification defines features by which individual specimens can be objectively graded and specific treatment recommendations are made based on the grade of the lesion. We propose that the term keratinocytic intraepidermal neoplasia (KIN) be used to define and describe evolving SCC of the skin and that the term actinic (solar) keratosis be eliminated.

Original languageEnglish (US)
Pages (from-to)3-14
Number of pages12
JournalSeminars in Cutaneous Medicine and Surgery
Volume18
Issue number1
StatePublished - 1999

Fingerprint

Actinic Keratosis
Squamous Cell Carcinoma
Skin
Terminology
Neoplasms
Cervical Intraepithelial Neoplasia
Dermis
Keratinocytes
Epidermis
Cervix Uteri
Uterine Cervical Neoplasms
Histology
Therapeutics
Radiation
Carcinoma
Biopsy

ASJC Scopus subject areas

  • Dermatology

Cite this

Incipient intraepidermal cutaneous squamous cell carcinoma : A proposal for reclassifying and grading solar (actinic) keratoses. / Yantsos, V. A.; Conrad, N.; Zabawski, E.; Cockerell, C. J.

In: Seminars in Cutaneous Medicine and Surgery, Vol. 18, No. 1, 1999, p. 3-14.

Research output: Contribution to journalArticle

@article{c138529fc9114282921f6fdfd75f80eb,
title = "Incipient intraepidermal cutaneous squamous cell carcinoma: A proposal for reclassifying and grading solar (actinic) keratoses",
abstract = "Actinic keratoses (AKs) are primarily induced by ultraviolet (UV) radiation and are often identified as premalignant lesions. In our opinion, AKs are proliferations of transformed, neoplastic keratinocytes confined to the epidermis that may eventually extend into the dermis, at which point they are termed squamous cell carcinoma (SCC). In contrast to AKs, SCCs have the potential to metastasize and kill. This process is analogous to that of evolving carcinoma of the uterine cervix that has been termed cervical intraepithelial neoplasia (CIN), a time-tested and reliable classification that provides clinicians with accurate information on which to base treatment decisions regarding cervical neoplasms following biopsy testing. A similar classification scheme could provide guidance to clinicians for the diagnosis and treatment of evolving SCC of the skin and as such, we propose a similar classification using the terminology keratinocytic intraepidermal neoplasia (KIN). This system is more reflective of the histology and natural history of SCC and eliminates ambiguity in the terminology of lesions currently referred to as AKs. The KIN classification defines features by which individual specimens can be objectively graded and specific treatment recommendations are made based on the grade of the lesion. We propose that the term keratinocytic intraepidermal neoplasia (KIN) be used to define and describe evolving SCC of the skin and that the term actinic (solar) keratosis be eliminated.",
author = "Yantsos, {V. A.} and N. Conrad and E. Zabawski and Cockerell, {C. J.}",
year = "1999",
language = "English (US)",
volume = "18",
pages = "3--14",
journal = "Seminars in Cutaneous Medicine and Surgery",
issn = "1085-5629",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Incipient intraepidermal cutaneous squamous cell carcinoma

T2 - A proposal for reclassifying and grading solar (actinic) keratoses

AU - Yantsos, V. A.

AU - Conrad, N.

AU - Zabawski, E.

AU - Cockerell, C. J.

PY - 1999

Y1 - 1999

N2 - Actinic keratoses (AKs) are primarily induced by ultraviolet (UV) radiation and are often identified as premalignant lesions. In our opinion, AKs are proliferations of transformed, neoplastic keratinocytes confined to the epidermis that may eventually extend into the dermis, at which point they are termed squamous cell carcinoma (SCC). In contrast to AKs, SCCs have the potential to metastasize and kill. This process is analogous to that of evolving carcinoma of the uterine cervix that has been termed cervical intraepithelial neoplasia (CIN), a time-tested and reliable classification that provides clinicians with accurate information on which to base treatment decisions regarding cervical neoplasms following biopsy testing. A similar classification scheme could provide guidance to clinicians for the diagnosis and treatment of evolving SCC of the skin and as such, we propose a similar classification using the terminology keratinocytic intraepidermal neoplasia (KIN). This system is more reflective of the histology and natural history of SCC and eliminates ambiguity in the terminology of lesions currently referred to as AKs. The KIN classification defines features by which individual specimens can be objectively graded and specific treatment recommendations are made based on the grade of the lesion. We propose that the term keratinocytic intraepidermal neoplasia (KIN) be used to define and describe evolving SCC of the skin and that the term actinic (solar) keratosis be eliminated.

AB - Actinic keratoses (AKs) are primarily induced by ultraviolet (UV) radiation and are often identified as premalignant lesions. In our opinion, AKs are proliferations of transformed, neoplastic keratinocytes confined to the epidermis that may eventually extend into the dermis, at which point they are termed squamous cell carcinoma (SCC). In contrast to AKs, SCCs have the potential to metastasize and kill. This process is analogous to that of evolving carcinoma of the uterine cervix that has been termed cervical intraepithelial neoplasia (CIN), a time-tested and reliable classification that provides clinicians with accurate information on which to base treatment decisions regarding cervical neoplasms following biopsy testing. A similar classification scheme could provide guidance to clinicians for the diagnosis and treatment of evolving SCC of the skin and as such, we propose a similar classification using the terminology keratinocytic intraepidermal neoplasia (KIN). This system is more reflective of the histology and natural history of SCC and eliminates ambiguity in the terminology of lesions currently referred to as AKs. The KIN classification defines features by which individual specimens can be objectively graded and specific treatment recommendations are made based on the grade of the lesion. We propose that the term keratinocytic intraepidermal neoplasia (KIN) be used to define and describe evolving SCC of the skin and that the term actinic (solar) keratosis be eliminated.

UR - http://www.scopus.com/inward/record.url?scp=0032956917&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032956917&partnerID=8YFLogxK

M3 - Article

VL - 18

SP - 3

EP - 14

JO - Seminars in Cutaneous Medicine and Surgery

JF - Seminars in Cutaneous Medicine and Surgery

SN - 1085-5629

IS - 1

ER -