Squamous Cell Carcinoma in situ Features


  • A: Epidermal Thickening
  • B: DEJ Alteration
  • C: Hyperkeratotic Layering



  • In most early SCCIS epidermal thickening is mainly focused to the Stratum Spinosum layer
  • Thickening of the Stratum Corneum layer can also be present
  • Increased prominence and thickness of the DEJ is typical for SCCIS
  • Increased DEJ thickness and increased hyporeflectivity of thickened Stratum Spinosum region linked to increased dysplastic cell content



  • Hyperreflective areas can sometimes be observed at the interface between the Stratum Corneum and Spinosum layers representing increased keratin deposition



  • Increased hyporeflectivity of the DEJ can in some cases make identifying the deep margin difficult, however there is always a textural change between the epidermal keratinocytes and the underlying collagen and adnexal structures.

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