Seborrheic keratosis

Diagnosis: Seborrheic keratosis

Case submitted by Murtuza Bandukwala to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Murtuza Bandukwala. Originally posted July 1, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Melanoma • Pigmented basal cell carcinoma • Verruca vulgaris • Solar lentigo • Actinic keratosis • Dermatosis papulosa nigra

Key Learnings

• Most common benign epithelial tumor — "stuck-on" waxy appearance • Dermoscopy: comedo-like openings, milia-like cysts, fissures/ridges, "brain-like" pattern • Sign of Leser-Trélat: sudden appearance of multiple eruptive SKs — associated with internal malignancy (controversial) • Dermatosis papulosa nigra: small SKs on face in individuals of African descent • Stucco keratoses: white, stuck-on SKs on lower extremities • No malignant potential — but pigmented SK can mimic melanoma clinically • Histology: acanthosis with horn cysts and pseudohorn cysts, squamous and basaloid cells

Tags: seborrheic, keratosis, murtuza bandukwala