Seborrheic keratosis: Reflectance confocal microscopy features and correlation with dermoscopy - 14/06/13
, Theresa Cao, DO b, Margaret Oliviero, ARNP b, Martin Laimer, MD a, Rainer Hofmann-Wellenhof, MD c, Harold S. Rabinovitz, MD b, d, Alon Scope, MD e, fAbstract |
Background |
Differentiation between seborrheic keratosis (SK) and skin cancers may be difficult. Reflectance confocal microscopy (RCM) enables noninvasive assessment of skin neoplasms at cellular-level resolution.
Objective |
We sought to describe RCM features of SK and to correlate these RCM findings with dermoscopic structures.
Methods |
Clinical, dermoscopic, and RCM images of 45 consecutive SK were obtained at a private and university dermatology clinic. Fourteen SK were biopsied because of equivocal clinical or dermoscopic features.
Results |
With RCM, all SK displayed a regular honeycomb pattern of the epidermis and densely packed, round to polymorphous, well-circumscribed dermal papillae at the dermoepidermal junction, features suggestive of a benign neoplasm. RCM features indicating the diagnosis of SK were also observed, including epidermal projections (43/45 SK; 96%) and keratin-filled invaginations (36/45 SK; 80%) at the lesion surface; corneal pseudocysts at epidermal layers (19/45 SK; 42%); and melanophages (21/45 SK; 47%) and dilated round and linear blood vessels (21/45 SK; 47%) in the papillary dermis. Of biopsied SK, 93% (13/14) displayed at least 3 characteristic RCM findings in the absence of RCM features suggestive of malignancy.
Limitations |
This was a limited study sample and retrospective study design.
Conclusions |
SK display a distinct set of RCM criteria despite their variable clinical and dermoscopic appearances.
Le texte complet de cet article est disponible en PDF.Key words : dermoscopy, histopathology, in vivo reflectance confocal microscopy, seborrheic keratoses, solar lentigo
Abbreviations used : BCC, DEJ, RCM, SCC, SK
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 69 - N° 1
P. 120-126 - juillet 2013 Retour au numéro
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