Clinical, dermoscopic and immunohistochemical assessment of actinic keratoses and evaluation of the effectiveness of diclofenac therapy with immunohistochemical analysis
| Autor: | Murat Demiriz, Mutlu Çayirli, Osman Köse |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Diclofenac Time Factors Keratosis Turkey Dermoscopy Dermatology Administration Cutaneous Severity of Illness Index Cytokeratin Predictive Value of Tests Medicine Neoplasm Humans Prospective Studies Prospective cohort study Aged Cell Proliferation Skin Aged 80 and over Keratin-19 Dermatoscopy Chi-Square Distribution medicine.diagnostic_test Cyclooxygenase 2 Inhibitors business.industry Keratin-15 Remission Induction General Medicine Middle Aged medicine.disease Immunohistochemistry Clinical trial Keratosis Actinic stomatognathic diseases Ki-67 Antigen Treatment Outcome Proto-Oncogene Proteins c-bcl-2 Female business Gels Biomarkers medicine.drug |
| Zdroj: | Archives of dermatological research. 305(5) |
| ISSN: | 1432-069X |
| Popis: | Actinic keratoses (AKs) is a keratinocytic neoplasm that typically develops on the face of elderly patients. Little is known regarding the clinical, dermatoscopic and immunohistochemical assessments of AK using topical diclofenac therapy. We sought to determine these assessments and evaluate the efficacy of topical diclofenac gel in AK. In this prospective, open-label study, 44 patients with 66 AKs were treated for 12 weeks with topically applied diclofenac (3% gel in 2.5% hyaluronic acid). Immunohistopathologic analyses were performed before and after diclofenac treatment using epidermal stem cell markers such as Cytokeratin 15 (CK15), Cytokeratin 19 (CK19) and p63, in addition to proliferation markers (Bcl-2, Ki-67). Diclofenac gel was found to be effective in AK, including the hyperkeratotic type. Surprisingly, complete remission was observed at a significantly higher rate in Grade 3 lesions (p = 0.017). However, imunohistochemical and histopathologic examinations revealed that 12-week treatment periods may not be sufficient to fully cure AK. The immunohistochemical analyses revealed no change in the expression levels of CK15, CK19 and Bcl-2 following diclofenac therapy. However, the expression of Ki-67 (p = 0.042) and p63 (p = 0.030) exhibited a significant decrease after therapy. Dermatoscopy is an effective method for diagnosis of AK, and topical diclofenac sodium gel was found as an effective additional treatment modality. Since positive histopathological findings were detected in some patients even with significant remission, a 12-week treatment period should be extended even in patients presenting with positive clinical response. Importantly, anti-proliferative effects of diclofenac were demonstrated by decreased Ki-67 and p63 expression levels. |
| Databáze: | OpenAIRE |
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