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Seborrheic keratosis: reflectance confocal microscopy features and correlation with dermoscopy.

Abstract：

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.

journal_name

J Am Acad Dermatol

journal_title

Journal of the American Academy of Dermatology

authors

Ahlgrimm-Siess V,Cao T,Oliviero M,Laimer M,Hofmann-Wellenhof R,Rabinovitz HS,Scope A

doi

10.1016/j.jaad.2012.12.969

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

120-6

issue

1

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(12)02379-1

journal_volume

69

pub_type

杂志文章

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