Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Acantholysis in SCC Not Considered High Risk

J Am Acad Dermatol; ePub 2016 Nov 23; Ogawa, et al

The presence of acantholysis in cutaneous squamous cell carcinoma (SCC) does not specifically confer aggressive behavior, a recent study found. Researchers sought to document clinical features, histologic features, management, and outcomes in a series of acantholytic SCC (aSCC) cases. Definitions of aSCC, acantholytic actinic keratosis (aAK), and aSCC arising in association with aAK were applied to a consecutive series of aSCC cases. Clinical characteristics and outcomes were obtained from electronic medical records. They found:

  • Of 115 aSCC cases (103 patients, mean age 71.8 years), actinic keratosis was present in 23% (27/115) but only 7.8% (9/115) exhibited associated aAK.
  • 10 cases (10/115, 9%) fulfilled strict histologic criteria for follicular SCC as previously defined, but 50 of 115 (43%) of the aSCC cases exhibited predominant involvement of follicular epithelium rather than epidermis.
  • Clinical outcome (median follow-up, 36 months) was available in 106 of 115 (92%).
  • One patient experienced regional extension (parotid), and 1 patient experienced a local recurrence (nose).
  • No disease-related metastases or deaths were documented.


Ogawa T, Kiuru M, Konia TH, Fung MA. Acantholytic squamous cell carcinoma is usually associated with hair follicles, not acantholytic actinic keratosis, and is not “high risk”: Diagnosis, management, and clinical outcomes in a series of 115 cases. [Published online ahead of print November 23, 2016]. J Am Acad Dermatol. doi:10.1016/j.jaad.2016.09.024.

This Week's Must Reads

Link Between AD and Autoimmune Disorders, J Am Acad Dermatol; ePub 2018 Oct 1; Narla, et al

Predictors of Mucosal Melanoma Survival, J Am Acad Dermatol; ePub 2018 Oct 5; Altieri, et al

Prevalence of Acne Vulgaris Among Patients with HS, J Am Acad Dermatol; ePub 2018 Oct 1; Wertenteil, et al

Skin Disease Epidemiology in a Diverse Population, J Drugs Dermatol; 2018 Oct; Gaulding, et al

Psoriasis Treatment Receives Tentative FDA Approval, Bausch Heath news release; 2018 Oct 8

Must Reads in Actinic Keratosis

Actinic Keratosis Treatment Burden in Medicare , JAMA Dermatology; ePub 2018 Sep 19; Yeung, et al

Red Light ALA PDT Well Tolerated in AK Treatment, Photomed Laser Surg; ePub 2017 Dec 11; Paragh, et al

Cost of Managing AK Varies by Region, JAMA Dermatol; ePub 2017 Mar 1; Kirby, et al

Physician Wording Role in Seeking AK Treatment, JAMA Dermatol; ePub 2017 Jan 18; Berry, Butt, et al

Acantholysis in SCC Not Considered High Risk, J Am Acad Dermatol; ePub 2016 Nov 23; Ogawa, et al