TY - JOUR
T1 - Seborrheic keratosis
T2 - Reflectance confocal microscopy features and correlation with dermoscopy
AU - Ahlgrimm-Siess, Verena
AU - Cao, Theresa
AU - Oliviero, Margaret
AU - Laimer, Martin
AU - Hofmann-Wellenhof, Rainer
AU - Rabinovitz, Harold S.
AU - Scope, Alon
PY - 2013/7
Y1 - 2013/7
N2 - 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.
AB - 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.
KW - dermoscopy
KW - histopathology
KW - in vivo reflectance confocal microscopy
KW - seborrheic keratoses
KW - solar lentigo
UR - http://www.scopus.com/inward/record.url?scp=84879085912&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2012.12.969
DO - 10.1016/j.jaad.2012.12.969
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C2 - 23415460
AN - SCOPUS:84879085912
SN - 0190-9622
VL - 69
SP - 120
EP - 126
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 1
ER -