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INTRODUCTION: Most cutaneous squamous cell carcinomas (cSCC) have a good prognosis, there is a small group where metastasis and death occur and the evaluation of this risk is still cause for controversy. Tumour budding is a pattern of histological invasion that is an emerging risk factor in other solid tumours. OBJECTIVE: To examine the association between tumour budding and other known high-risk predictors in cSCC. In addition, the impact of tumour budding on overall survival (OS) and disease-specific survival (DSS) was analysed. METHOD: Retrospective study. It included patients with a diagnosis of non-genital cSCC by excisional biopsy at a university hospital, between 2010 and 2020. A pathologist re-analysed their histological slides and evaluated budding. Univariate and multivariate analyses were made to study the associations. RESULTS: 156 cSCC biopsies were found, and positive tumour budding was found in 13.5%. This correlated with worse DSS and OS. On univariate analysis, budding was correlated with the diameter, thickness of the tumour, histological grade, level of invasion, perineural and lymphovascular invasion, previous radiotherapy, recurrent tumours and lymph node metastasis (LNM). Multivariate analysis: tumour budding was associated with poorly differentiated tumours, prior radiotherapy and LNM. CONCLUSION: An association was found between tumour budding and most known risk factors in cSCC. We found findings that indicate that the presence of tumour budding is associated with a worse prognosis in terms of LNM, OS and DSS. This supports the results of previous work which has suggested that budding could be related to high-risk cSCC.

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Introducción: en otros países se han descrito ciertos factores relacionados con el desarrollo de queratosis actínica (QA). Objetivo: describir las características clínicas, epidemiológicas e histopatológicas de pacientes institucionales de Medellín, con diagnóstico de QA. Metodología: estudio descriptivo de pacientes con QA. Se aplicó una encuesta estructurada tomando datos demográficos, clínicos y relacionados con el desarrollo de la QA. Resultados: se incluyeron 153 pacientes (58 hombres [37,9%] y 95 mujeres [62,1%]), con edad promedio de 70 años. Tenían 75 años o más 64 pacientes (41,8%). Ciento ocho pacientes (70,6%) refirieron haber tenido un grado alto de exposición solar en la niñez; 76 (49,7%) tenían el antecedente de fumar y 16 de estos (21,1%) aún fumaban; 46 (30,1%) informaron el antecedente de un familiar con cáncer de piel. Setenta y tres (47,7%) realizaban las actividades tanto bajo techo como al aire libre; 80 (52,3%) informaron que se aplicaban protector solar y 37 (24,4%) usaban gorra o sombrero por la época en que fueron encuestados. Predominó el fototipo II (101 pacientes; 66%) y había daño actínico moderado en 76 (49,7%). Cuando hubo un solo patrón histológico predominó el atrófico (12%) y cuando hubo dos, el atróficohiperqueratósico (18,7%). Conclusiones: las características fenotípicas y de exposición de los pacientes con QA estudiados en Medellín (Colombia) son similares a las reportadas en la literatura.

Introduction: Several factors related with the development of actinic keratosis (AK) have been reported in other countries. Objective: To describe the clinical, epidemiological and histopathological characteristics of patients with diagnosis of AK in Medellín, Colombia. Methodology: This was a descriptive study of patients with AK. A structured survey including demographic, clinical and epidemiological information was applied. Results: 153 patients were included (58 men [37.9%] and 95 women [62.1%]) with an average age of 70 years. Sixty four patients (41.8%) were aged 75 years or more. With regard to their personal history, 108 individuals (70.6%) had a high degree of solar exposure during childhood; 76 (49.7%) reported the habit of smoking and 16 out of these (21.1%) still smoked. In 46 (30.1%) there was a family history of skin cancer. Regarding individual habits, 73 (47.7%) carried out both indoor and outdoor activities, 80 (52.3%) reported the use of sunscreen and 37 (24.4%) used hat or cap at the time of the study. Fitzpatrick´s type II phototype predominated (101 patients; 66%) and 76 (49.7%) had moderate actinic damage. The predominant single histologic subtype corresponded to the atrophic type (12%) and the main mixed subtype was the atrophichyperkeratotic subtype (18.7%). Conclusions: Clinical, epidemiological and histopathological features found among two institutional populations with AK in Medellin (Colombia) were similar to those reported in the literature.

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