Solar Keratosis Can Be Distinguished from Superficial Basal Cell Carcinoma by Expression of bcl-2

Abstract

Criteria for the histological diagnosis of solar keratosis (SK) and superficial basal cell carcinoma (SBCC) are well defined. On occasion, however, the distinction can be difficult, particularly when evaluating small-punch or superficial shave biopsies in which the overall global architectural pattern of the lesion is not represented. As bcl-2 expression has been established in basal cell carcinoma, this study was undertaken to determine whether it could be employed as a basis for distinguishing SBCC from SK. Ten cases each of typical SBCC and SK were studied. Every example of SBCC showed strong uniform expression of the bcl-2 gene product Bcl-2, whereas all examples of SK were uniformly negative. It is suggested, therefore, that this simple technique is a reliable method for distinguishing these two closely related but disparate lesions.