Histopathological analysis of the therapeutic response to cryotherapy
               with liquid nitrogen in patients with multiple actinic keratosis

Oliveira, Marina Câmara de; Trevisan, Flávia; Pinto, Clovis Antônio Lopes; Xavier, Célia Antônia; Pinto, Jaqueline Campoi Calvo Lopes

doi:10.1590/abd1806-4841.20153302

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Sumário

Dermatopathology • An. bras. dermatol. 90 (3) • June 2015 • https://doi.org/10.1590/abd1806-4841.20153302 copy

Histopathological analysis of the therapeutic response to cryotherapy with liquid nitrogen in patients with multiple actinic keratosis^* * Work performed at the Dermatology Service da Faculdade de Medicina de Jundiaí (FMJ) – Jundiaí (SP), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Actinic keratoses are premalignant lesions of the skin caused by excessive sun exposure. Lesions may become mainly squamous cell carcinoma. Cryotherapy with liquid nitrogen is one of the main treatments. In order to evaluate the response of actinic keratosis to cryotherapy by histopathology, two lesions were selected in each of 14 patients with multiple actinic keratoses. In one lesion a biopsy was performed and in the other lesion a biopsy was performed after cryotherapy. Subsequently, both biopsies were compared histologically. Of the thirteen patients who completed the study, the best results were obtained in lesions undergoing cryotherapy concerning the atypia of keratinocytes, epithelial thickness and corneal layer and lymphocytic infiltrate. Despite the small number of patients, it was concluded that, if performed correctly, cryotherapy has high efficacy in the treatment of actinic keratoses.

Keywords
Cryotherapy; Histology; Keratosis, actinic

Ptnt	Atypia		Epidermis		Cornea		Elastosis		Infiltrate
	Pre	Post	Pre	Post	Pre	Post	Pre	Post	Pre	Post
1	M	L	0.13	0.10	0.60	0.05	0.30	0.55	M	A
2	A	A	0.17	0.10	0.20	0.15	0.30	0.13	M	A
3	M	L	0.10	0.08	0.10	0.05	0.45	0.40	M	M
4	L	L	0.06	0.19	0.10	0.20	0.52	0.50	A	A
5	M	L	0.55	0.08	0.50	0.05	1.00	2.00	M	A
6	L	L	0.10	0.05	0.05	0.05	0.20	0.25	A	A
7	M	L	0.15	0.06	0.45	0.15	0.65	0.90	I	L
8	M	A	0.45	0.20	0.33	0.01	1.10	1.00	L	A
9	M	M	0.20	0.31	0.25	0.30	1.20	1.00	M	M
10	L	A	0.12	0.22	0.22	0.25	0.40	0.50	L	A
11	I	L	0.40	0.21	0.25	0.10	0.00	0.00	M	A
12	M	A	0.28	0.20	0.23	0.15	0.30	1.50	I	A
13	M	L	0.35	0.36	0.45	0.35	0.30	0.55	L	A

Criteria	Percentage of cases with provement after cryotherapy	Percentage of cases with im absent criterium
Atypia of keratinocytes	76.92	0
Thickness of epithelium	69.23	0
Thickness of cornea	69.23	0
Thickness of elastosis	33.93	7.69
Lymphocitary infiltrate	69.23	15.38

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Histopathological analysis of the therapeutic response to cryotherapy with liquid nitrogen in patients with multiple actinic keratosis* * Work performed at the Dermatology Service da Faculdade de Medicina de Jundiaí (FMJ) – Jundiaí (SP), Brazil.

Abstract

Histopathological analysis of the therapeutic response to cryotherapy with liquid nitrogen in patients with multiple actinic keratosis^* * Work performed at the Dermatology Service da Faculdade de Medicina de Jundiaí (FMJ) – Jundiaí (SP), Brazil.