Retrospective Analysis Of Clinical And Pathological Features In 148 Cases Of Actinic Keratosis

Objective: To discuss and summarize the clinical and pathological characteristics of actinic keratosis,to increase the re-understanding of actinic keratosis,and to guide clinical diagnosis and treatment.Methods: The clinical and pathological data of 148 patients pathologically diagnosed with actinic keratosis from October 2010 to October 2020 at Zunyi Medical University were retrospectively analyzed,and the clinical and pathological characteristics of skin diseases that are easily confused with actinic keratosis were also compared and analyzed.Results: One hundred and forty-eight cases were included,of which 44(30%)were male;104(70%)were female;the male to female ratio was 1:2.36;the age distribution ranged from 41 to 92 years.The lesion sites were mainly on the cheek,face and nose.The clinical and pathological diagnostic conformity rate was 27.03%.The first clinical diagnosis of 148 AK patients confirmed by pathology was mostly seborrheic keratosis,basal cell carcinoma,dermatokeratosis,and Bowen’s disease.The histopathological features of AK were: alternating columns of hyperkeratosis and hyperkeratosis,epidermal atrophy or irregular hyperplasia,hyperplasia of atypical keratin-forming cells in the subepidermal layer,deep staining of the nucleus,disorganized cell arrangement,and some epidermal protrusions in the form of bud buds.The superficial dermal elastic fibers were degenerated,the superficial collagen was basophilic,and the lymphocytes were infiltrated in varying amounts.Conclusion:1.Actinic keratosis has diverse lesion manifestations at different times,and it is clinically easy to be confused with seborrheic keratosis,basal cell carcinoma,squamous cell carcinoma,and Bowen’s disease,which needs to be combined with dermatoscopy,histopathology,and immunohistochemistry when diagnosis is difficult.AK typical lesions appear as thickened,well-defined hyperkeratotic plaques,erythema,and tenderness on palpation in patients.2.Epidermal lower middle 1/2 keratin-forming cells with anomalous shape and disorganized cell arrangement are the main features of AK pathological changes.Intradermal inflammatory cell infiltration was more obvious in both c SCC and AK histopathology,suggesting a role of inflammatory cells in the development and transformation of tumors.3.Some patients with AK transform to squamous cell carcinoma,and this risk increases with age and disease duration,so early diagnosis,treatment and management of AK patients is very important.