The diagnostic value of p63, p16, and p53 immunohistochemistry in distinguishing seborrheic keratosis, actinic keratosis, and Bowen's disease

Abstract

Seborrheic keratosis (SK), actinic keratosis (AK), and Bowen's disease (BD) are squamoproliferative disorders of the skin. Histologically, they may mimic each other and therefore, they might be misinterpreted, especially in small samples. The aim of this study is to clarify the expression of p63, p16, and p53 proteins in SK, AK, and BD and evaluate the efficacy of these markers in order to distinguish between the aforementioned lesions. A total of 46 cases were collected (15 SK, 16 AK, and 15 BD) and stained for p63, p16, and p53. The stain intensity and the cell distribution labeling were scored and then analyzed by SPSS software. All cases of BD which became positive for p53 revealed basal keratinocytes sparing. Instead, all or nearly all basal keratinocytes in AK cases were positive for this marker. These were also seen in p16 staining results and they were between AK and BD (P = .024). Our study demonstrates p16 and p53 are useful markers in separating AK and BD according to basal keratinocytes involvement and sparing, respectively.

Seborrheic Keratosis With Malignant Transformation (Invasive or Noninvasive Squamous Cell Carcinoma Arising in Seborrheic Keratosis): A Clinicopathologic and Immunohistochemical Study of 11 Cases

“…In this study, the components of pre-existing seborrheic keratosis always contained a few scattered p16-positive cells as reported in previous studies, 52–54 although these p16-positive cells may be colonizing melanocytes. Carcinoma in situ arising in seborrheic keratosis was frequently (86%, 6/7) positive for p16, but invasive carcinoma tended to lose p16 expression (75%, 3/4).…”

Differentiating pagetoid Bowen disease from Paget disease on the nipple‐areola complex: Two unique, challenging cases

“…In cutaneous squamous cell carcinomas, its expression is variable, and generally it is more prominent in immature or poorly differentiated cells, 19 although some studies have not found a significant association between positivity and the degree of differentiation of the tumor 17 . Some other studies suggest that the distinct results might be because of the different antibodies used in each case 22 …”

“…17 Some other studies suggest that the distinct results might be because of the different antibodies used in each case. 22 The expression of these stains in normal cells can sometimes make the interpretation of its positivity harder, which might render them slightly less useful than other stains in the differential diagnosis between Paget disease and pagetoid Bowen disease. Something that can help in pointing toward pagetoid Bowen disease might be that, generally, p63 is positive in almost all layers of the epidermis in its presence, while in normal epidermis and in Paget disease it is usually restricted to basal and suprabasal cells.…”

p63 immunoexpression in hair follicles of normal and alopecia X‐affected skin of Pomeranian dogs

“…The staining intensity was scored for positive p63 nuclei as strong, moderate and weak according to Nasiri et al 22 and blindly by two operators (LDS, MR). The basal epidermal layer served as strong internal intensity reference control for p63.…”