Treatment-resistant actinic keratoses (trAK) are painful and show acantholysis with distinct basal proliferation, according to a recent study published in Italian Journal of Dermatology and Venereology.
“This study aimed to investigate trAKs after field therapy compared to randomly chosen [actinic keratoses (AKs)] prior to treatment,” wrote the study authors.
Researchers clinically assessed AKs according to the hyperkeratosis grade and pain on palpation, prior to treatment. They were evaluated by histological severity (AKI-III), their basal growth grading (PROI-III), acantholysis, elastosis, follicular extension of atypical keratinocytes, and accompanying infiltrate.
Upon analysis, trAKs were more painful and showed acantholysis with distinct basal proliferation compared with the control group. Pain and PROIII-graded lesions were predictors for trAKs. AKs with grade AKIII, PROIII or follicular extension reaching the sebaceous gland were the most common histological findings.
“TrAKs are often painful, showing a distinct basal proliferation (PROIII) and acantholysis,” concluded the study authors. “As these features are also seen in invasive [cutaneous squamous cell carcinomas], trAKs may represent a subgroup of AKs and, for this reason, it requires further evaluations,” they continued. –Lisa Kuhns
Reference
Schmitz L, Brehmer A, Falkenberg C, et al. Treatment-resistant actinic keratoses are characterized by distinct clinical and histological features. Ital J Dermatol Venerol. 2021;156(2):213-219. doi:10.23736/S2784-8671.21.06892-9
