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The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation
Author(s) -
Lallas A.,
Pyne J.,
Kyrgidis A.,
Andreani S.,
Argenziano G.,
Cavaller A.,
Giacomel J.,
Longo C.,
Malvestiti A.,
Moscarella E.,
Piana S.,
Specchio F.,
HofmannWellenhof R.,
Zalaudek I.
Publication year - 2015
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.13510
Subject(s) - medicine , pathology , cellular differentiation , carcinoma , odds ratio , basal cell , biology , biochemistry , gene
Summary Background Little is known about the variability of the dermoscopic criteria of squamous cell carcinoma ( SCC ) according to the histopathological differentiation grade. Objectives To evaluate whether specific dermoscopic criteria can predict the diagnosis of poorly differentiated SCC compared with well‐ and moderately differentiated SCC . Methods Clinical and dermoscopic images of SCC s were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver–operator characteristic curves. Results Of 143 SCC s included, 48 (33·5%) were well differentiated, 45 (31·5%) were moderately differentiated and 50 (35·0%) were poorly differentiated. Flat tumours had a fourfold increased probability of being poorly differentiated. Dermoscopically, the presence of a predominantly red colour posed a 13‐fold possibility of poor differentiation, whereas a predominantly white and white–yellow colour decreased the odds of poorly differentiated SCC by 97% each. The presence of vessels in more than 50% of the tumour's surface, a diffuse distribution of vessels and bleeding were significantly associated with poor differentiation, while scale/keratin was a potent predictor of well‐ or moderately differentiated tumours. Conclusions Dermoscopy may be regarded as a reliable preoperative tool to distinguish poorly from well‐ and moderately differentiated SCC . Given that poor differentiation of SCC represents an independent risk factor for recurrence, metastasis and disease‐specific death, identifying poorly differentiated tumours in vivo may enhance their appropriate management.