Skin Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Skin Cancer, including details on identification, causes, prevention, treatment.

Fluorescence diagnosis in keratinocytic intraepidermal neoplasias.

Smits T, Kleinpenning MM, Blokx WA, van de Kerkhof PC, van Erp PE, Gerritsen MJ

Department of Dermatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. t.smits@derma.umcn.nl

BACKGROUND: As different tissue types have distinct capabilities to accumulate protoporphyrin-IX, fluorescence diagnosis with aminolevulinic acid-induced porphyrin (FDAP) could be used to discriminate between different tissue types. OBJECTIVE: Protoporphyrin-IX accumulation and proliferation were studied in cutaneous squamous (pre)malignancies to see whether FDAP could be used to discriminate between different stages of keratinocytic intraepidermal neoplasia or proliferative status. METHODS: FDAP was performed in 14 patients (86 lesions) and biopsy specimens were taken, on which (immuno)histochemistry was performed for histopathologic classification and assessment of Ki67-antigen expression. Stratum corneum thickness was also measured. RESULTS: The fluorescence ratio (lesional:nonlesional skin) showed neither significant differences between the different keratinocytic intraepidermal neoplasia stages, nor between different levels of Ki67-antigen expression. Macroscopic fluorescence intensity and stratum corneum thickness were negatively correlated. LIMITATIONS: Relatively few malignancies were biopsied. CONCLUSIONS: With FDAP we were not able to discriminate between keratinocytic intraepidermal neoplasia lesions or proliferative activity. However, hyperkeratosis appeared to be an important determinant in variations in macroscopic fluorescence intensity.

Published 17 October 2007 in J Am Acad Dermatol, 57(5): 824-31.
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