ANTI-HUMAN EPITHELIAL ANTIGEN (BER-EP4) HELPS DEFINE BASAL-CELL CARCINOMA MASKED BY INFLAMMATION

BACKGROUND. Anti-human epithelial antigen (Dako-Ber-EP4) is an antibod y raised in mice that reacts with two glycoproteins of 34 and 49 kD. T hese glycoproteins are present on the cell surface and in the cytoplas m of basal cell carcinoma (BCC) cells, sweat glands, and some hair fol licles in the skin. METHODS. We selected 27 BCCs (15 nodular, 11 morph eic/infiltrative, and one adenoid) and one trichoblastoma and performe d rapid immunohistochemical studies with Ber-EP4 and a labeled strepta vidin biotin alkaline phosphatase system. RESULTS. Twenty-seven of 27 BCCs and one of one trichoblastoma mere positive for Ber-EP4. Thirteen of 27 BCCs stained with Ber-EP4 showed areas of BCC in dense inflamma tion that were better defined by the Ber-EP4 immunostain than by the H &E stain. In two cases persistent infiltrative BCC was found in the fi nal Mohs margins while appearing negative with routine H&E. Several in stances occurred where negative Ber-EP4 in inflammatory fields resulte d in tissue sparing with the avoidance of a further Mohs (insurance) l ayer. CONCLUSION. In conclusion, we found mouse anti-human Ber-EP4 a u seful and reliable marker for BCC. This antibody helps to locate Inten t BCC tumor in inflammatory Mohs margins. (C) 1997 by the American Soc iety for Dermatologic Surgery, Inc.