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Ultrastructural and morphological analysis during progression of Bowen disease reveals a complex interplay between hyperkeratosis, cytokeratin expression, host immunity and amyloid deposition

  • Investigative Report
  • Published:
European Journal of Dermatology

Abstract

Background

Bowen disease, one of the common skin cancers, is defined as squamous cell carcinoma in situ, characterized by atypical keratinocytes occupying the full thickness of the epidermis, and predominantly occurs on sun-protected skin. There is no existing data on the impact of tumour and immune cell interactions or cytokeratin expression on the pathology of Bowen disease.

Objectives

We analysed dynamic changes in cytokeratin expression and immune cell composition during the development and progression of Bowen disease.

Materials & Methods

Analysis was performed using immunohistochemistry and electron microscopy for samples from 140 patients with Bowen disease and 20 patients with invasive squamous cell carcinoma. We evaluated cytokeratin expression, the number of infiltrating immune cells and amyloid deposition by immunohistochemistry, and the ultrastructural relationship between tumour cells and immune cells by electron microscopy.

Results

The results showed that the expression of CK14 is associated with tumour progression, keratotic status and amyloid deposition and that the expression of CK10 is associated with accumulation of immune cells in Bowen disease. The findings of electron microscopy indicated repeated battles involving immune cells in response to tumour invasion.

Conclusion

The expression of cytokeratins, hyperkeratosis, inflammatory infiltration and amyloid deposition are useful findings indicating the “stage” in Bowen disease.

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Acknowledgements

We thank Ms. Yuko Edano, Ms. Miwako Kobayashi and Ms. Asami Moriyama for the assistance with immunohistochemistry and special staining.

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Authors and Affiliations

  1. Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Japan

    Hiroyuki Goto, Kazunari Sugita, Takashi Horie & Osamu Yamamoto

  2. Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan

    Kazunari Sugita

Authors
  1. Hiroyuki Goto
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  2. Kazunari Sugita
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  3. Takashi Horie
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  4. Osamu Yamamoto
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Correspondence to Hiroyuki Goto.

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Conflicts of interest: Hiroyuki Goto has received funding for this research from MSD K.K.

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Goto, H., Sugita, K., Horie, T. et al. Ultrastructural and morphological analysis during progression of Bowen disease reveals a complex interplay between hyperkeratosis, cytokeratin expression, host immunity and amyloid deposition. Eur J Dermatol 33, 207–217 (2023). https://doi.org/10.1684/ejd.2023.4497

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  • DOI: https://doi.org/10.1684/ejd.2023.4497

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