Kin - Altmeyers Encyclopedia - Department Dermatology

Definition
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Acronym for "keratinocytic intraepithelial neoplasia" analogous to the acronyms: CIN, AIN, PIN.

Classification
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Clinically, the following distinct clinical pictures are subsumed under KIN:
- The different Variants of the keratosis actinica
- M. Bowen.
Histologically, a distinction is made depending on the occurrence and density of the atypical keratinocytes:
- KIN I: Lower third of the epithelium (early in situ SCC - KIN I or AKI)
- KIN II: Lower two thirds of the epithelium (early in situ SCC - KIN II or AKI)
- KIN III: Complete infestation of the epithelium; (Carcinoma in situ . KINIII or AK III)

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Histology
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Loss of normal skin stratification. Often nuclear polymorphisms, hyperchromasia, development of coliocytosis. Bulky superficial round cell infiltrates, basement membrane intact. In the lichenoid type of AK an interface dermatitis is found which reminds of a lichen planus. Tab.

Tables
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Stadium	Dysplasia/Grading	Histological description
KIN I	mild dysplasia	Small cellular atypias, often koilocytes with enlarged irregular nuclei and halo.
CHIN II	Moderate dysplasia	Replacement of up to 50% of the epithelium by atypical keratinocytes with increased nuclear plasma ratio.
KIN III	Severe dysplasia/carcinoma in situ	Replacement of > 50% of the surface epithelium including adnexal structures by atypical, partly also binuclear keratinocytes; increased number of mitoses.

Note(s)
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Classification not yet generally usual. S.u. Keratosis actinica.

Literature
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Cockerell CJ (2000) Histopathology of incipient intraepidermal squamous cell carcinoma ("actinic keratosis"). J Am Acad Dermatol 42: 11-17
Fu W, Cockerell CJ (2003) The actinic (solar) keratosis: a 21st-century perspective. Arch Dermatol 139: 66-70
Yantsos VA et al (1999) Incipient intraepidermal cutaneous squamous cell carcinoma: a proposal for reclassifying and grading solar (actinic) keratoses. Semin Cutan Med Surg 18: 3-14