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Diagnostic concordance of intraepithelial malignancy is generally only fair. B ecause the diagnosis of actinic keratosis (AK) and squamous cell carcinoma (SCC) is not uniform and because such terms are not consonant with the nomenclature o f other human epithelial malignancies, nomenclature revisions have been attempte d. One hundred dermatopathologists were solicited to review 15 tissue sections r epresenting a spectrum of varying thickness epidermal malignancy and to choose e ither AK or SCC as the diagnosis. Among the 77 participating dermatopathologists , intraclass correlation was high for what was perceived as AK, SCC, and their d ifferentiation. Development of a two-tiered diagnostic system that retains our present diagnostic capabilities, but better fits the pathobiology of superficial epidermal malignancy is suggested.
Diagnostic concordance of intraepithelial malignancy is generally only fair. B ecause the diagnosis of actinic keratosis (AK) and squamous cell carcinoma (SCC) is not uniform and therefore such terms are not consonant with the nomenclature of other human epithelial malignancies, nomenclature revisions have been attempte d. One hundred dermatopathologists were solicited to review 15 tissue sections r epresenting a spectrum of varying thickness epidermal malignancy and to choose eherher AK or SCC as the diagnosis. Among the 77 participating dermatopathologists, intraclass correlation was high for what was perceived as AK , SCC, and their d of differentiation. Development of a two-tiered diagnostic system that retains our present diagnostic capabilities, but better fits the pathobiology of superficial epidermal malignancy is suggested.