Korean J Dermatol.  2012 Mar;50(3):220-226.

The Differential Expression of Lysyl Oxidase in Keratoacanthoma and Squamous Cell Carcinoma

Affiliations
  • 1Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea. sdpark@wku.ac.kr
  • 2Department of Pathology, Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
  • 3Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

Abstract

BACKGROUND
Because keratoacanthoma (KA) and squamous cell carcinoma (SCC) are very similar with respect to clinical and histological features but are different with respect to prognosis and treatment, it is necessary to differentiate these two diseases. A number of recent studies have been attempted to differentiate these two diseases using immunohistochemical stains; however, the results obtained using these approaches were inconsistent.
OBJECTIVE
The purpose of this study was to examine the expression pattern of polyclonal antibody to lysyl oxidase (LOX) on KA and SCC using an immunohistochemical staining method, and to evaluate the ability of this method in distinguishing these two diseases.
METHODS
The expression of LOX in 10 cases of KA and 10 cases of SCC, which were confirmed by histopathologic examination, and 10 cases of normal human skin as a control, were evaluated using an immunohistochemical staining method. We divided the degree of immunohistochemical staining into three classifications --high density, low density, and no density-- based on the level of the expression of LOX in the epidermis and the tumor. Evaluation of the immunohistochemical staining was performed by two dermatologists and one pathologist.
RESULTS
The rates of high, low, and no density in KA were 50%, 50%, and 0%, respectively. The rates of high, low, and no density in SCC were 40%, 10%, and 50%, respectively. The rates of high, low, and no density in the control group were 70%, 30%, and 0%, respectively.
CONCLUSION
Because the degree of LOX expression in KA and SCC was very diverse, it could not be reliably used as a differential stain for the two diseases. But interestingly, no LOX expression was observed in SCC. This suggests that if expression of LOX is absent, there is a high probability of being diagnosed with a malignant skin tumor rather than a benign skin tumor.

Keyword

Differential diagnosis; Keratoacanthoma; Lysyl oxidase; Squamous cell carcinoma

MeSH Terms

Carcinoma, Squamous Cell
Diagnosis, Differential
Epidermis
Humans
Keratoacanthoma
Prognosis
Protein-Lysine 6-Oxidase
Skin
Protein-Lysine 6-Oxidase
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