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Correspondence |

Actinic Keratosis on a Continuum With Squamous Cell Carcinoma

Robert M. Hurwitz, MD; Larry J. Buckel, MD
Arch Dermatol. 2010;146(8):918-935. doi:10.1001/archdermatol.2010.182.
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The erudite article, “Gene Expression Patterns of Normal Human Skin, Actinic Keratosis, and Squamous Cell Carcinoma” by Padilla et al,1 published in the March 2010 issue of the Archives, is long awaited and applauded by those who hold the view that an actinic keratosis (AK) is a type, and the earliest stage on a continuum, of squamous cell carcinoma (SCC). In contrast to those who have perceived AK as a benign lesion, those who have considered it to be malignant by clinical and histopathologic findings were thought to be implacable and sometimes pariahs.24 Those who consider AK a malignant lesion are bolstered by the conclusions of Padilla et al1 that “The finding of similar differentially expressed genes in AK and SCC confirms that AK is a precursor of SCC and that they are closely related genetically,”1(p292) and that “AK and SCC . . . demonstrated a continuum and an expansion of gene expression along this disease spectrum.”1(p292)

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