3. Solar keratosis

 
Quotation from the 9th edition of Lever's:
 
"Actinic keratosis and solar cheilitis can develop into squamous cell carcinoma. However, the incidence of this transformation is difficult to determine, because the borderline between actinic keratosis and squamous cell carcinoma is not clear-cut."
 
"It has been estimated that in 20% of patients with actinic keratosis squamous cell carcinoma develops in one or more of the lesions (191)."
 
"Actinic keratosis are keratinocytic dysplasias or squamous cell carcinomas in situ. This definition is preferable to their designation as precancerous, because most of them never progress to cancers."
 
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA):
 
Ackerman AB. What is the boundary that separates a thick solar keratosis and a thin squamous cell carcinoma? Am J Dermatopathol. 1984;6:305.
 
No reference to ideas of ABA published since 1984.
 
Statements contrary by ABA:
 
"solar keratosis is not a premalignant lesion but a malignant neoplasm, i.e., a squamous-cell carcinoma.* And that is the reason why no textbook of dermatology, general pathology, or dermatopathology has ever stated cogently, or ever will, where solar keratosis ends and squamous-cell carcinoma begins (solar keratosis is an incipient squamous-cell carcinoma). And that is precisely the reason why "Darier type" solar keratosis is "pseudoglandular" squamous-cell carcinoma in miniature (solar keratosis/squamous-cell carcinoma is a continuum). And that is precisely the reason why the cytologic features of the neoplastic cells of solar keratosis are indistinguishable from those of thicker squamous-cell carcinomas (the two conditions, despite their different names, are fundamentally one and the same)."
 
Ackerman AB. Editorial. Respect at last for solar keratosis. Dermatopathology Practical & Conceptual 3(2):101-103, 1997.
 
Other works of ABA in which the ideas contrary are expressed:
 
1. Solar Keratosis (video), available at: www.derm101.com, 2005.
 
2. Ackerman AB. Opposing views of 2 academies about the nature of solar keratosis. Cutis 2003; 71: 391-395.
 
3. Ackerman AB. Solar keratosis is squamous cell carcinoma. Arch Dermatol. 2003 Sep;139(9):1216-7.
 
4. Ackerman AB. Holden Caulfield, solar keratosis, and the American Academy of Dermatology. Dermatopathology: Practical & Conceptual 9(4), 2003.
 
5. Kessler GM, Ackerman AB. Nomenclature for very superficial squamous-cell carcinoma of the skin and of the cervix: a critique in historical perspective. Dermatopathology: Practical & Conceptual 9(4), 2003.
 
6. Ackerman AB. Response by Dr. Ackerman to letter by B. Allen Flaxman. J Am Acad Dermatol. 45(3):467-469, 2001.
 
7. Ackerman AB. Actinic keratoses—malignant or not? J Am Acad Dermatol. 45:466-9, 2001.
 
8. Javier BJ, Ackerman AB. Solar keratosis with "Darier-like features" is "pseudoglandular" squamous-cell carcinoma. Dermatopathology: Practical & Conceptual 6(2):114-121, 2000.
 
9. Heaphy MR Jr, Ackerman AB. The nature of solar keratosis: a critical review in historical perspective. J Am Acad Dermatol. 2000 Jul;43(1 Pt 1):138-150.
 
10. G-Beato Merino MJ, Ackerman AB. Solar keratoses have not been proven to regress! Dermatopathology: Practical & Conceptual 0:5-9, 2000.
 
11. Brand D, Ackerman AB. Squamous cell carcinoma, not basal cell carcinoma, is the most common cancer in humans. J Am Acad Dermatol. 2000.
 
12. Jones EC, Ackerman AB. About the matter of solar keratosis. Dermatopathology: Practical & Conceptual 5(4):303–11, 1999.
 
13. Ackerman AB, Ragaz A. The Lives of Lesions: Chronology in Dermatopathology. Masson Publishing USA, 1984. (Now on list of Ardor Scribendi, NYC.)