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Seborrheic keratosis (SK) is a common, benign tumor that can occur on every body site and can be conservatively managed. Cosmetic concerns, especially when a lesion involves the facial area, is the most common reason for excision. SK shows male gender preponderance and increasing age is an independent association with the condition. Even though mor...
Citations
... In contrast, seborrheic keratosis is a benign epidermal tumor with no malignant potential [9]. Clinical management of SK typically involves lesion removal for cosmetic reasons or symptomatic relief [20]. Treatments for SK include cryotherapy, curettage, electrocautery, laser therapy, and topical agents such as salicylic acid or retinoids [20,21]. ...
... Clinical management of SK typically involves lesion removal for cosmetic reasons or symptomatic relief [20]. Treatments for SK include cryotherapy, curettage, electrocautery, laser therapy, and topical agents such as salicylic acid or retinoids [20,21]. Additionally, while AK lesions may require regular monitoring and surveillance due to their potential for malignant transformation, SK lesions generally do not necessitate long-term follow-up unless symptomatic or cosmetically concerning [20]. ...
... Treatments for SK include cryotherapy, curettage, electrocautery, laser therapy, and topical agents such as salicylic acid or retinoids [20,21]. Additionally, while AK lesions may require regular monitoring and surveillance due to their potential for malignant transformation, SK lesions generally do not necessitate long-term follow-up unless symptomatic or cosmetically concerning [20]. Overall, while both AK and SK may present with similar clinical manifestations, their treatment approaches are tailored to their underlying pathology and associated risks, emphasizing the importance of accurate diagnosis and appropriate management strategies in dermatological practice. ...
... SK mostly occurs in middle-aged and older individuals, and presents with various clinical manifestations. 18 The rate of misdiagnosis as SK is evidently heterogeneous in fair-skinned populations, 8,21 and was lower in our study than that in recent reports from China and South Korea. 7, 14 Karadag et al suggested that this heterogeneity may be due to differences in patients' populations, insufficient initial diagnosis data, and other factors. ...
Purpose
The rising incidence and mortality associated with cutaneous malignant tumours highlight the importance of early diagnosis of these tumors. In clinical practice, these tumors are often misdiagnosed as benign skin lesions such as melanocytic nevi (MN) and seborrheic keratosis (SK) because of their similar morphologic features. The incidence and clinicopathological subtypes of cutaneous malignancies in East Asia populations significantly differ from those in fair-skinned groups. However, studies on misdiagnoses in Eastern countries are lacking. Therefore, this study focused on the clinical and pathological features of cutaneous malignant tumors misdiagnosed as MN or SK in a Chinese population.
Patients and Methods
A total of 4592 samples clinically diagnosed as MN (n = 3503) or SK (n = 1089) from July 2014 to June 2022 were collected and evaluated retrospectively. The clinical and pathological data were analyzed to identify associated factors.
Results
Pathological assessments showed that 2.5% (86/3503) of the specimens clinically diagnosed as MN were malignancies, predominantly basal cell carcinoma (BCC, 84.9%, 73/86), followed by malignant melanoma (MM, 8.1%, 7/86) and squamous cell carcinoma (SCC, 7.0%, 6/86). Similarly, 5.7% (62/1089) of the specimens clinically diagnosed as SK were malignant tumors, of which BCC (50.0%, 31/62) was the most common, followed by SCC (41.9%, 26/62) and MM (8.1%, 5/62). In both types of specimens, advanced age and facial lesions were risk factors for malignancy misdiagnosis. The malignancy rate, mean age, and proportion of SCC in the specimens clinically diagnosed as SK were higher than those in the specimens clinically diagnosed as MN. Dermoscopy significantly reduced the rate of misdiagnosis of these tumors as MN or SK.
Conclusion
In China, cutaneous malignant tumors misdiagnosed as MN or SK are not uncommon in clinical practice, and active introduction of noninvasive diagnostic techniques is essential to distinguish them.
... Currently, the gold standard for assessing the severity of keratosis relies on visual evaluation, a subjective approach that employs descriptive terms like mild, moderate, severe, or very severe [28][29][30][31][32][33][34]. Regrettably, these terms often fail to convey a precise clinical picture to the recipient. ...
Excessive epidermal hyperkeratosis in acral areas is a common occurrence in dermatology practice, with a notable prevalence of approximately 65% in the elderly, especially in plantar lesions. Hyperkeratosis, characterized by thickening of the stratum corneum, can have various causes, including chronic physical or chemical factors, genetic predispositions, immunological disorders, and pharmaceutical compounds. This condition can significantly impact mobility, increase the risk of falls, and reduce the overall quality of life, particularly in older individuals. Management often involves creams containing urea to soften hyperkeratotic areas. Currently, subjective visual evaluation is the gold standard for assessing hyperkeratosis severity, lacking precision and consistency. Therefore, our research group proposes a novel 6-point keratinization scale based on dermatoscopy with cross-polarization and parallel-polarization techniques. This scale provides a structured framework for objective assessment, aiding in treatment selection, duration determination, and monitoring disease progression. Its clinical utility extends to various dermatological conditions involving hyperkeratosis, making it a valuable tool in dermatology practice. This standardized approach enhances communication among healthcare professionals, ultimately improving patient care and research comparability in dermatology.
... 1,2 It manifests with a sudden appearance or rapid accumulation of multiple seborrheic keratoses on the chest, abdomen, or back. 2 Seborrheic keratoses are waxy-textured papules that are black or brown in color and characterized by their appearance of being stuck onto the skin. 3 Seborrheic keratoses are themselves benign skin growths that grow slowly over a number of years, but their accumulation or sudden appearance (often within one year) can be a sign of an underlying malignancy. 1,4 The most common malignancies associated with LTS are those of the gastrointestinal tract, in Clinical Practice and Cases in Emergency Medicine ...
Case presentation:
Early diagnosis and rapid treatment of cancer is essential for good clinical outcomes for patients. In this case, an 85-year-old man presented with failure to thrive and was noted to have rapid-onset, multiple seborrheic keratoses (Leser-Trélat sign) on his chest and back. He was ultimately diagnosed with pancreatic cancer using computed tomography.
Discussion:
Leser-Trélat sign is a rare cutaneous marker for underlying malignancy. Identification of this sign can help guide diagnostic imaging and lab work to identify an occult internal malignancy, resulting in more rapid diagnosis, earlier treatment, and potentially better clinical outcomes.
... But the latest data, on the contrary, indicate the «rejuvenation» of dermatosis [18]. As for the appearance of SK within the genitals, infection with the human papillomavirus is considered to be the predominant trigger in such cases [19,20]. This etiological factor can be dominant in immunocompromised patients with skin manifestations of keratosis [12]. ...
Seborrheic keratosis (SK) remains the leader among benign skin pathologies. In the classical sense, extragenital foci of this dermatosis look like light or dark brown papules with dense hyperkeratotic or verrucous layers. Such a clinical picture is characteristic of the typical form of foci of skin lesions. The etiopathogenetic mechanisms of SK appearance are not sufficiently studied, because a large number of trigger factors are reported. Given the benign profile of these lesions, practitional doctors very often do not pay much attention to these foci. While for patients, their appearance and increase in size can cause the emergence of obsessive or anxiety states both due to the development of cancer-phobic states due to significant aesthetic discomfort.The objective: to determine the peculiarities of the course of seborrheic keratosis in women, taking into account anamnestic data on the effect of insolation on the skin and phenotypic criteria represented by the skin phototype, as well as to analyze the dermatological quality of life indicator in patients with keratosis depending on the location of neoplasms.Materials and methods. Based on the Educational and Scientific Medical Center «University Clinic» of Zaporizhzhia State Medical and Pharmaceutical University, 50 patients with foci of seborrheic keratosis, whose ages ranged from 27 to 80 years old, were examined. To verify the diagnosis, the following parameters were carried out: a clinical examination of neoplasms with an assessment of the phenotypic criterion – skin phototype according to Fitzpatrick, dermatoscopic and pathomorphological examination. The assessment of the impact of keratosis on the quality of life of patients was based on the calculation of the results of the DLQI (Dermatology Life Quality Index) questionnaire.Results. The studied sample is represented by the majority of representatives of the II phototype – 44 persons and a small number of the III phototype – 6 patients, which amounted to 88% and 12%, respectively. The most frequent localization of keratosis was the head – 18 (36%), torso – 11 (22%), extremities – 13 (26%), and neck – 8 (16%). This location on open areas of the body can be an additional confirmation of the effect of ultraviolet radiation on the occurrence of keratosis. According to the results of the questionnaire with the study of anamnestic data, more than half of the examined patients (58%) had skin burns after a long stay in the open sun. In addition, an insufficient level of use of photoprotective agents was determined. All these factors can be as triggers for the appearance of keratosis foci and negatively affect the self-esteem and aesthetic appeal of patients. Indeed, when efflorescences are located in visual areas of the body, the dominant factor is a decrease in the quality of life.Conclusions. Predominance of patients with II skin phototype (88%) and lack of photoprotection skills (48% never use sunscreen, 32% sometimes) are the most influential factors in determining insolation as one of the leading triggers of seborrheic keratoma formation. Localization of keratosis foci on open areas of the body to a greater extent negatively affects the quality of life of women, demonstrating higher DLQI index values – 7 points – versus 5 points in the women with the keratomas on the torso. Therefore, increasing the level of awareness among patients about sun exposure, the use of photoprotection and regular examination is a priority task for doctors of all levels.
A 75-year-old man presented with an abdominal enlarging painless tumor of the skin evolving over the last 30 years. His past medical history was unremarkable. Physical examination revealed a brownish pedunculated cutaneous mass which had an irregular keratotic warty surface with no discharge or ulceration. The mass was clinically presumed to be a melanocytic tumor, or a verrucous carcinoma. A monoblock excision of the mass was performed with a good outcome. The specimen was then sent to our pathology department to rule out malignancy. Macroscopic examination revealed a brownish tumor of 7.5 × 7 × 1.5 cm which had fissures and cauliflower-like appearance. Final histological report concluded to a giant seborrheic keratosis.
