Patterns of LC3A Autophagy Protein Expression in Keratoacanthomas

  • Efthimios SivridisEmail author
  • Ioannis M. Koukourakis
  • Stella Arelaki
  • Kostantina Balaska
  • Antonios Karpouzis
  • Alexandra Giatromanolaki
Original Paper


To investigate the expression patterns of autophagy marker light chain protein 3 (LC3A) in keratoacanthoma (KA). KAs are generally regarded as benign but malignant behavior, including rare metastases, may occur. 85 KAs were assessed for the LC3A autophagic protein by immunohistochemistry. Diffuse cytoplasmic staining and a “stone-like structure” (SLS) characterized positive expression. Thirty-four out of 85 KAs (40%) had diffuse cytoplasmic LC3A immunostaining (percentage of positive cells ranging from 5 to 60%). In contrast, only 4 of the 85 KAs (4.7%) expressed SLSs. Only one SLS was detected per histologic section of each tumor. The p53 oncoprotein was encountered in all cases with expression ranging from 1 to 90% of cells (median 30%). The Ki-67 index was expressed in 63 cases (74% of cases; range 1–50% of cells; median value 5%). Neither of these two parameters nor diffuse cytoplasmic LC3A staining was significantly correlated with SLS expression or lack thereof. Expression of SLSs, a hallmark of malignancy, was found in 4.7% of KAs. Further study is necessary to determine whether this fraction represents the exceptional cases that harbor latent malignant potential.


Keratoacanthoma Autophagy LC3A Stone-like structures P53 Ki67 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Departments of PathologyDemocritus University of Thrace Medical School and University General Hospital of AlexandroupolisAlexandroupolisGreece
  2. 2.Departments of DermatologyDemocritus University of Thrace Medical School and University General Hospital of AlexandroupolisAlexandroupolisGreece

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