Evaluation of dermoscopic algorithm for seborrhoeic keratosis: a prospective study in 412 patients

Lin, Jingrong; Han, Shichao; Cui, Li; Song, Zhiqi; Gao, M.; Guang, Yang; Fu, Yan; Liu, X.

doi:10.1111/jdv.12241

Cited by 44 publications

(42 citation statements)

References 12 publications

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“…Our results are in line with previous studies highlighting the dermoscopic variability of SKs [2]. 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].…”

Section: Discussionsupporting

confidence: 82%

“…The diagnosis is readily made by clinical and dermoscopic examination in the majority of cases. Dermoscopically, classic SKs usually show multiple milia-like cysts, comedo-like openings, fissures/ridges (brain-like appearance), light brown fingerprint-like structures, and sharply demarcated borders [2]. Given their benign nature, treatment is not mandatory.…”

Section: Introductionmentioning

confidence: 99%

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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: 82%

Section: Introductionmentioning

confidence: 99%

Unusual Dermoscopic Patterns of Seborrheic Keratosis

Squillace

Cappello²,

Longo³

et al. 2016

Dermatology

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“…Only two of the 146 lesions (1.4%) presented sharp demarcations. This may aid their differentiation from SK, which was reported to present sharp demarcation in about 70% of the cases …”

Section: Discussionmentioning

confidence: 93%

“…Since BD shares some dermoscopic features with SK, BCC, etc., it is hard to define a dermoscopic algorithm for BD. In order to facilitate the differentiation from other skin diseases, we summarized the dermoscopic differential diagnosis of BD in Table , including SK, BCC, AK, MM, LPLK, MPD, and LMM …”

Section: Discussionmentioning

confidence: 99%

What's new in dermoscopy of Bowen's disease: two new dermoscopic signs and its differential diagnosis

et al. 2017

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“…Dermoscopy is particularly useful for the recognition of SK, as the dermoscopic criteria of the tumour are very peculiar and quite‐specific (Fig. ) …”

Section: False‐positive Tumoursmentioning

confidence: 99%

The limitations of dermoscopy: false‐positive and false‐negative tumours

Papageorgiou

Apalla

Sotiriou

et al. 2018

Acad Dermatol Venereol

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Dermoscopy has been documented to increase the diagnostic accuracy of clinicians evaluating skin tumours, improving their ability to detect skin cancer and better recognize benign moles. However, dermoscopically 'false-positive' and 'false-negative' tumours do exist. False-positive diagnosis usually leads to unnecessary excisions. False-negative diagnosis is much more dangerous, as it might result in overlooking a cancer, with severe undesirable consequences for the patient and the physician. Therefore, management strategies should mainly focus on addressing the risk of dermoscopically false-negative tumours. The most frequent benign tumours that might acquire dermatoscopic characteristics suggestive of malignancy are seborrhoeic keratosis (SK), including solar lentigo, melanoacanthoma, irritated, clonal and regressive SK, angioma (mainly thrombosed angioma and angiokeratoma), dermatofibroma, benign adnexal tumours and naevi (Clark, Spitz, recurrent, combined, sclerosing). The most useful clues to recognize these tumours are the following: solar lentigo - broad network; melanoacanthoma - sharp border; irritated SK - regularly distributed white perivascular halos; clonal SK - classic SK criteria; regressive SK - remnants of SK; targetoid haemosiderotic haemangioma - dark centre and reddish periphery; thrombosed angioma - sharp demarcation; angiokeratoma - dark lacunae; atypical dermatofibromas - palpation; follicular tumours - white colour; sebaceous tumours - yellow colour; Clark naevi - clinical context; Spitz/Reed naevi - age; combined naevi - blue central area; recurrent naevi - pigmentation within the scar; sclerosing naevi - age and location on the upper back; blue naevi - history. Malignant tumours that might mimic benign ones and escape detection are melanoma (in situ, nevoid, spitzoid, verrucous, regressive, amelanotic), squamous cell carcinoma (mainly well-differentiated variants) and rarely basal cell carcinoma (non-pigmented variants). The most useful clues to recognize the peculiar melanoma subtypes are as follows: melanoma in situ - irregular hyperpigmented areas; nevoid melanoma - history of growth; spitzoid melanoma - age; verrucous melanoma - blue-black sign; regressive melanoma - peppering or scar-like depigmentation; amelanotic melanoma - pink colour, linear irregular vessels, dotted vessels. In this article, we summarized the most frequent dermoscopic variations of common skin tumours that are often misinterpreted, aiming to assist clinicians to reduce the number of false diagnoses.

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Evaluation of dermoscopic algorithm for seborrhoeic keratosis: a prospective study in 412 patients

Abstract: Seborrhoeic keratosis may present a variety of dermoscopic patterns and features. The combination of lack of blue-grey or blue-white colour, sharp demarcation, mica-like structure and yellowish colour with the two-step algorithm could improve its diagnostic accuracy.

Cited by 44 publications

References 12 publications

Unusual Dermoscopic Patterns of Seborrheic Keratosis

Unusual Dermoscopic Patterns of Seborrheic Keratosis

What's new in dermoscopy of Bowen's disease: two new dermoscopic signs and its differential diagnosis

The limitations of dermoscopy: false‐positive and false‐negative tumours

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