ABSTRACT
BACKGROUND: There is a major controversy over the natural behavior of keratoacanthoma (KA). KAs have been described as benign lesions, but also as variants of squamous cell carcinoma (SCC). Microscopic differentiation between these 2 entities is problematic, and sometimes impossible. Syndecan-1 (CD138) is an adhesion molecule whose expression appears to be inversely correlated with tumor invasiveness. Elevated Ki-67 expression is indicative of a high proliferation index, a feature of malignant tumors. METHODS: Syndecan-1 and Ki-67 expression were assessed in 22 KA skin samples and in 17 SCC skin biopsies. RESULTS: Syndecan-1 expression was diminished in the SCC specimens compared with the KA specimens ( P =.000). Ki-67 expression was increased in the SCC specimens compared with the KA specimens, with mean values of 9 and 0.08, respectively ( P =.000). LIMITATIONS: Further studies that compare intermediate risk KAs to typical KAs and SCCs are required to corroborate these findings. CONCLUSION: The assessment of syndecan-1 and Ki-67 expression in skin biopsies is a helpful tool for differentiating KA and SCC
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Keratoacanthoma/diagnosis , Skin Neoplasms/diagnosis , Biopsy , Carcinoma, Squamous Cell/genetics , Gene Expression Regulation , Gene Expression Regulation, Neoplastic , Humans , Keratoacanthoma/genetics , Ki-67 Antigen/genetics , Skin Neoplasms/genetics , Syndecan-1/geneticsABSTRACT
OBJECTIVES: To determine gene frequencies of HLA-DR alleles in 22 Mexican patients with focal epithelial hyperplasia and compare them with those present in ethnically matched healthy subjects, as well as to determine the types of human papillomavirus present in the lesions. DESIGN: Prospective and retrospective observational study. SETTING: Dermatology outpatient clinic in a general hospital. PATIENTS: Twenty-two patients with clinically and histologically confirmed focal epithelial hyperplasia seen within a 10-year period. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Results of high-resolution DNA typing for HLA-DR alleles and biopsy for viral typing. RESULTS: HLA-DR4 (DRB1*0404) was significantly increased (P<.001; odds ratio, 3.9; 95% confidence interval, 1.86-8.03). Seventeen (85%) of 20 patients had human papillomavirus subtype 13. The data on human papillomavirus differed from reports elsewhere that described association with human papillomavirus type 32. CONCLUSIONS: The HLA-DRB1*0404 allele suggests that Amerindian populations are at risk, and in this group, the Mexican population studied was affected only by human papillomavirus type 13.
