What Predictors Differentiate ISK From SCC?
Dotted vessels, branched linear vessels, white structureless areas, white circle surrounding follicles predict SCC
By Dermsquared Editorial Team | October 13, 2021
There are potent predictors that differentiate between irritated seborrheic keratosis (ISK) and squamous cell carcinoma (SCC), according to a study published in the November issue of the Journal of the American Academy of Dermatology.
Chryssoula Papageorgiou, M.D., from Aristotle University in Greece, and colleagues examined the dermoscopic criteria that could serve as predictors for the differential diagnosis between ISK and SCC. Dermoscopic images were evaluated for the presence of predefined criteria by three independent investigators.
Overall, 104 SCCs and 61 ISKs were included. The researchers found that dotted vessels (odds ratio, 10.4), branched linear vessels (odds ratio, 5.30), white structureless areas (odds ratio, 6.78), white circles surrounding follicles (odds ratio, 23.45), a diffuse irregular or peripheral vessel arrangement (odds ratios, 2.55 and 2.8), and a central scale arrangement (odds ratio, 3.35) were the main dermoscopic predictors of SCC. Hairpin vessels (odds ratio, 0.38), a diffuse regular vessel arrangement (odds ratios, 0.39 and 0.36), and white halos surrounding vessels covering more than 10 percent of the lesion (odds ratios, .0.29 and 0.12) were negative predictors of SCC and consequently positive dermoscopic predictors of ISK.
"We confirmed the significant morphologic overlap between ISK and SCC, but we also identified potent predictors for the differential diagnosis between these two entities that may enhance the clinical diagnosis in everyday practice," the authors write.