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Actinic keratosis: correlation between clinical and histological classification systems
Author(s) -
Schmitz L.,
Kahl P.,
Majores M.,
Bierhoff E.,
Stockfleth E.,
Dirschka T.
Publication year - 2016
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13626
Subject(s) - medicine , actinic keratosis , dermatology , grading (engineering) , histology , correlation , keratosis , pathology , civil engineering , geometry , mathematics , basal cell , engineering
Background There are several clinical and histological classification systems for grading actinic keratosis ( AK ) lesions. The Olsen clinical classification scheme grades AK lesions according to their thickness and degree of hyperkeratosis (grades 1–3). The Roewert‐Huber histological classification system grades AK lesions based on the extent of epidermal atypical keratinocytes ( AK I– III ). Objective The aim of this study was to determine whether there is a correlation between these clinical and histological AK classification schemes. Methods One AK lesion from patients in three pivotal clinical studies and routine practice was assessed clinically and histologically. A match in grading was defined as Olsen grade 1 being classified histologically as AK I, Olsen grade 2 as AK II and Olsen grade 3 as AK III . Results Of the 892 lesions included, 29.0% were classified as Olsen grade 1, 59.6% as Olsen grade 2 and 11.3% as Olsen grade 3; 19.2% were histologically classified as AK I, 69.6% as AK II and 11.2% as AK III . Only 480 lesions (53.8%) had a matching clinical and histological classification. Of these matches, most were ‘Olsen grade 2 = AK II ’ (83.1%). The Spearman's rank correlation coefficient for clinical and histological classification was r = 0.0499 ( P = 0.137). Conclusions Clinical classification of AK lesions using the system of Olsen does not accurately match histological classification of the same lesions using the system of Roewert‐Huber. Consequently, it is not possible to draw conclusions about the histology of AK lesions from their clinical appearance. This finding reinforces the need to treat all AK lesions as well as field cancerization.