Sebaceous Induction In Dermatofibroma: A Common Feature of Dermatofibromas On The Shoulder (original) (raw)

Journal of Cutaneous Pathology

Background: Dermatofibroma (DF) has multiple histopathological variants and overlying acanthosis, hyperkeratosis and hyperpigmentation are often present. We have frequently observed sebaceous induction in DFs on the shoulder and wanted to assess if this is a site-specific finding. Methods: We prospectively collected 100 DFs and assessed for sebaceous induction, the histopathologic pattern of the DF and any associated-epidermal changes. We retrospectively searched for DFs with sebaceous induction to assess the anatomic site of the biopsy. Results: In the 100 prospectively collected DFs, 49% occurred on the lower extremities, 39% on the upper extremities, 10% on the trunk and 2% on the head. Sebaceous induction was present in 16 DFs, 81% of which occurred on or near the shoulder. The most common variant was fibrocollagenous DF (64%), including in DFs with sebaceous induction. The retrospective search for DFs with sebaceous induction found 19 cases in which 95% occurred on the shoulder area. Sclerotic pattern DFs were most common in this retrospective cohort (47%), and seborrheic keratosis-like hyperplasia occurred in 100% of these cases. Conclusion: DFs occurring on the shoulder have a high incidence of sebaceous induction with seborrheic keratosis-like epidermal hyperplasia and a fibrocollagenous or sclerotic pattern.

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Dermoscopic Analysis of 72 “Atypical” Seborrheic Keratoses

Actas Dermo-Sifiliográficas, 2019

Background: Seborrheic keratoses (SK) are easily recognizable by clinical and dermoscopic approach, nevertheless, some lesions act as a simulator of different skin conditions lacking typical clinical and dermoscopic criteria. Objective: The aim of our study was to find specific dermoscopic features or a global pattern to improve diagnostic skills for challenging SK. Materials and methods: We examined 72 atypical SK excised from September 2014 up to September 2017 by using the 2-step algorithm modified by Malvehy (2002) and Argenziano (2003). Results: In our study population, an average of 4.04 out of 15 dermoscopic specific criteria for SK was found (for example, multiple milia-like cysts). Additional criteria not included in 2-step algorithm were blue-whitish veil (found in 3 SK; 4.2%), polymorphous vessels (18 SK; 25%), blotch/globules (6 SK; 8.3%), shiny white streaks (3 lesions; 4.2%). The most represented global patterns were reticular (27 SK; 37.5%) and not specific (15 SK; 20.8%). All lesions exhibited peculiar findings of SK, furthermore elements suggestive for melanocytic lesion were found in 79.2% of all lesions. Comparing the literature and our results, we found 3 significant differences: a) the less prevalence of SK specific criteria in our study population; b) the description of findings usually not related to SK, among which blue-whitish veil, polymorphous vessels, blotch/globules and shiny white streaks, and c) 2 patterns not previously defined represented by ''not specific pattern'' (20.9% of all lesions examined) and ''vascular pattern'' (12.5% of all lesions examined) were also described. No specific feature or global pattern, statistically significant for dermoscopic diagnosis of difficult-to-diagnose SK have been found. Conclusion: Nevertheless the useful findings, no specific feature or global pattern statistically significant for dermoscopic diagnosis of challenging SK have been found. According to the 2-step algorithm and the dermatoscopic scoring system for melanocytic and not melanocytic lesion, SK with one or more dermatoscopic findings typical of melanocytic lesion should be removed surgically to exclude classic melanoma or melanoma mimicking SK.

Dermoscopic Patterns of Dermatofibroma

Dermatologic Surgery, 2006

BACKGROUND. Clinical and dermoscopic aspects of dermatofibroma (DF) are usually typical. Systematic analysis of dermoscopic features of DFs has rarely been performed.

Dermatoscopic Findings of Seborrheic Keratosis in Melanoma

Acta dermatovenerologica Croatica : ADC, 2016

Cutaneous melanoma may in some instances be confused with seborrheic keratosis, which is a very common neoplasia, more often mistaken for actinic keratosis and verruca vulgaris. Melanoma may clinically resemble seborrheic keratosis and should be considered as its possible clinical simulator. We report a case of melanoma with dermatoscopic characteristics of seborrheic keratosis and emphasize the importance of the dermatoscopy algorithm in differentiating between a melanocytic and a non-melanocytic lesion, of the excisional biopsy for the establishment of the diagnosis of cutaneous tumors, and of the histopathologic examination in all surgically removed samples.

Regressing seborrheic keratosis - clinically and dermoscopically mimicking a regressing melanoma

Acta dermatovenerologica Croatica : ADC, 2007

The diagnosis of seborrheic keratosis is a clinical diagnosis. In a certain percentage of cases, differential diagnosis between seborrheic keratosis and malignant melanoma is difficult. We describe a case of regressing seborrheic keratosis simulating malignant melanoma. Clinical, dermoscopic and histopathologic examinations were performed for the occurrence of an asymmetric, irregularly demarcated, irregularly pigmented lesion measuring 1.3 x 1.5 cm on the right part of the abdomen in a 76-year-old male Caucasian. In order not to miss melanoma, the excision and histopathologic examination of the lesion with peppering is essential.

Unusual site of a common skin lesion - Seborrheic keratosis

IP Archives of Cytology and Histopathology Research

Seborrheic keratosis is common benign cutaneous tumour in the elderly which usually presents as pigmented lesion with stuck on appearance. It is seen on the head and neck region. Ear is an uncommon site for Seborrheic keratosis. Seborrheic keratosis is associated with sun- exposure, HPV and mutations in the FGFR3 and PIK3CA gene, but the pathophysiology is still not very clearly understood. We present a case in 60 years old lady who presented with a dark brown pigmented, cerebriform growth in the concha near the external auditory canal associated with reduced hearing and discharge on and off. Clinical suspicion was keratoacanthoma but the histopathological examination showed irritated and pigmented variant of Seborrheic keratosis. Seborrheic keratosis seldom needs to be treated since most of the patients are asymptomatic and get treated for cosmetic purpose but in this present case the patient was symptomatic, hence the mass was excised.

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