Clonal Seborrheic Keratosis: A Dermoscopic Pitfall

Zalaudek, Iris; Ferrara, Gerardo; Argenziano, Giuseppe

doi:10.1001/archderm.140.9.1169-b

Cited by 19 publications

(20 citation statements)

References 4 publications

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“…Clonal, blue-nevus-like, lichenoid and reticular SKs have been previously described as those often mimicking basal cell carcinoma, blue nevus, melanoma and nevi, respectively [3,4,5,6,7,8]. Based on our study, the dermoscopic variability of SKs seems to be even wider than previously reported [3].…”

Section: Discussionsupporting

confidence: 60%

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Unusual Dermoscopic Patterns of Seborrheic Keratosis

Squillace

Cappello²,

Longo³

et al. 2016

Dermatology

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Background: Seborrheic keratoses (SKs) may sometimes mimic benign and malignant skin tumors, and a biopsy can be necessary in order to rule out malignancy. Methods: From the database of our pigmented lesion clinic, we evaluated the dermoscopic features of difficult-to-diagnose SKs that were biopsied between January 2010 and December 2014. Results: SKs represented 3.8% of all excised lesions (161/ 4,182). Specifically, 91 (56.5%) were excised to rule out melanoma, 63 (39.1%) to rule out squamous cell carcinoma and 7 (4.4%) to rule out basal cell carcinoma. The following 10 global dermoscopic patterns were identified: multicomponent (32; 19.9%); reticular (24; 14.9%), characterized by an irregular pigment network; bowenoid (21; 13.0%); hairpin (19; 11.8%); keratoacanthoma-like (16; 9.9%); blue-nevus-like (15; 9.3%); lichenoid (6; 3.7%); hyperkeratotic (6; 3.7%); clonal (5; 3.1%); spitzoid (5; 3.1%). Furthermore, 12 SKs (7.5%) were not included in any of such patterns (not classified). Conclusion: Our results are in line with previous studies highlighting the dermoscopic variability of SKs. Although excised SKs may be classified into 1 of 10 repetitive dermoscopic patterns, a biopsy remains mandatory for those that cannot be clearly differentiated from common skin malignancies.

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Section: Discussionsupporting

confidence: 60%

“…Blue-nevus-like and lichenoid keratosis can be difficult to differentiate from melanoma. Reticular SKs have been previously described as often mimicking melanoma and nevi [3,4,5,6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

Unusual Dermoscopic Patterns of Seborrheic Keratosis

Squillace

Cappello²,

Longo³

et al. 2016

Dermatology

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“…Only Zalaudek et al [8] observed, in a pigmented SK, large bluish areas composed by numerous globule-like structures not homogeneously distributed, similar to the blue-gray ovoid nests of basal cell carcinoma. All these lesions resulted at histopathologic examination as clonal subtype SK.…”

Section: Discussionmentioning

confidence: 99%

The Blue Globular Pattern in Dermoscopy

et al. 2013

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Background: Seborrheic keratosis (SK) is a frequent benign epithelial skin tumor. Generally its diagnosis is clinical, however SK can sometimes clinically simulate a melanocytic lesion; therefore we need dermoscopy to reach a correct diagnosis. Milia-like cysts and comedo-like openings are the common dermoscopic features of SK, but it is not a rare finding that SK can display one or more dermoscopic patterns suggestive of a melanocytic origin. Objectives: We describe a case series of SKs with a blue globular pattern simulating a melanocytic lesion. Methods: We retrospectively evaluated 224 SKs seen during 2011 at the Dermatoscopy Unit of the Department of Dermatology, University of Rome ‘Sapienza'. Results: Five SKs showed a blue globular pattern, without the SK main features generally seen in dermoscopy; globules were multiple, round or oval, well-demarcated, small and medium-sized, blue-colored and equally distributed within the lesion. Histopathologic examination was consistent with acanthotic SK. Conclusions: Identification of the blue globular pattern can be helpful for the dermoscopic diagnosis of SK, especially when its common dermoscopic features are absent.

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“…Although dermoscopy is a helpful diagnostic tool for atypical seborrheic keratoses, the clonal variant may represent a dermoscopic pitfall. 1 Clonal seborrheic keratoses present with bluebrown globules and milia-like cysts on dermoscopy, 2 but vascular structures have not been described to our knowledge. We present an unusual acquired red patch in a young patient, showing polymorphic vessels on a diffuse pink and whitish background with white network.…”

Section: Key Messagesmentioning

confidence: 94%