Non Invasive Diagnostic Techniques in Clinical Dermatology by Enzo Berardesca Howard I. Maibach & Klaus-Peter Wilhelm

Author:Enzo Berardesca, Howard I. Maibach & Klaus-Peter Wilhelm
Language: eng
Format: epub
Publisher: Springer Berlin Heidelberg, Berlin, Heidelberg

22.5 Diagnostic CSSS in Cutaneous Neoplasms

Some epithelial neoplasms display characteristic aspects on CSSS [4, 5]. Seborrheic keratoses show spotty lenticular foci of soft hyperkeratosis. Widening of shallow furrows with hyperkeratosis is present. Samples of actinic keratosis often exhibit irregular thickness with interfollicular parakeratosis and xerosis. Actinic porokeratosis is revealed by the rim of cornoid lamellation and loss of the normal microrelief inside the lesion. Verrucous surfaces overlying melanocytic nevi and dermatofibromas are less pathognomonic, but sharp circumscription by a normal-looking surrounding skin and uniformity of the changes in the texture of the SC are usually seen in a benign neoplasm.

In CSSS taken from pigmented neoplasms, melanin can be found inside corneocytes or in atypical melanocytes. Melanin located only inside corneocytes is a feature of benign neoplasms, such as lentigines and solar lentigines. Presence of atypical melanocytes in the SC is strongly suggestive of malignant melanoma, but also, in rare instances, of a benign melanoacanthoma [4, 5, 34–36]. Thus, CSSS proves to be sensitive and specific in the distinction between malignant melanoma and benign melanocytic tumours such as common melanocytic nevi, dysplastic nevi or pigmented seborrheic keratoses [27]. For research purposes, karyometry of neoplastic melanocytes can be performed on CSSS [35, 36]. Basal cell carcinomas and squamous cell carcinomas do not exhibit specific or suggestive features on CSSS.

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