{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:53:36Z","timestamp":1780052016332,"version":"3.53.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T00:00:00Z","timestamp":1465862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100008271","name":"LEO Pharma Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008271","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Actinic keratosis (<jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>) usually co\u2010exists in areas of severe photodamage, but the clinical applicability of reflectance confocal microscopy (<jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>) in diagnosing <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> currently depends on a set of parameters yet to be defined in comparison to photodamaged skin (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To correlate the <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> features of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> with histopathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty participants with a mean age of 64\u00a0years and skin phototype I and II were studied. <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> was performed on two <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and one <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> within a field of 25\u00a0cm<jats:sup>2<\/jats:sup> on the left dorsal forearm, followed by shave biopsies. Blinded evaluation of the histopathological and <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> images using established parameters in <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> were performed retrospectively in consensus with an expert confocalist, correlated with the histopathological diagnosis by a board\u2010certified dermatopathologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 57\/60 areas were included. There were 43\/57 (75%) and 14\/57 (25%) histopathologically confirmed <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> respectively. Individual corneocytes, stratum corneum disruption, dermal inflammatory cells, increased vascularity\/dilated vessels and solar elastosis were detected in <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> upon histopathology and <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>. The features in favour of <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> were parakeratosis, hyperkeratosis, more severe keratinocyte pleomorphism and architectural disruption, and the presence of epidermal inflammatory cells. <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> also demonstrated keratinocyte pleomorphism and architectural disruption though this was generally less severe than <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>. A small subset of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> exhibited a comparable degree of keratinocyte pleomorphism and architectural disruption to the <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content>s in the cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The viable epidermis demonstrates <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> to be part of a disease continuum corresponding to field cancerization. Individual corneocytes, stratum corneum disruption, dermal inflammatory cells, increased vascularity\/dilated vessels and solar elastosis may be present in <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>; whereas, parakeratosis and hyperkeratosis may represent the key to distinguishing <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> using <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>. The significance of epidermal inflammatory cells in the <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> diagnosis of <jats:styled-content style=\"fixed-case\">AK<\/jats:styled-content> remains to be elucidated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.13699","type":"journal-article","created":{"date-parts":[[2016,6,14]],"date-time":"2016-06-14T07:28:22Z","timestamp":1465889302000},"page":"1901-1911","source":"Crossref","is-referenced-by-count":21,"title":["Histopathology and reflectance confocal microscopy features of photodamaged skin and actinic keratosis"],"prefix":"10.1111","volume":"30","author":[{"given":"J.M.","family":"Tan","sequence":"first","affiliation":[{"name":"Dermatology Research Centre The University of Queensland School of Medicine Translational Research Institute Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Lambie","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre The University of Queensland School of Medicine Translational Research Institute Brisbane Queensland Australia"},{"name":"IQ Pathology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sinnya","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre The University of Queensland School of Medicine Translational Research Institute Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Sahebian","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre The University of Queensland School of Medicine Translational Research Institute Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.P.","family":"Soyer","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre The University of Queensland School of Medicine Translational Research Institute Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.W.","family":"Prow","sequence":"additional","affiliation":[{"name":"Dermatology Research Centre The University of Queensland School of Medicine Translational Research Institute Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Ardig\u00f2","sequence":"additional","affiliation":[{"name":"San Gallicano Dermatological Institute Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,14]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12434"},{"key":"e_1_2_5_3_1","volume-title":"Dermatology","author":"Soyer HP","year":"2012"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12420"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.107497"},{"key":"e_1_2_5_6_1","first-page":"1216","article-title":"Solar keratosis squamous cell carcinoma in\u00a0situ","volume":"139","author":"Ackerman AB","year":"2003","journal-title":"J Am Acad Dermatol"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.103344"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12833"},{"key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1159\/000366541","volume-title":"Actinic Keratosis. 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