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Desmoplastic seborrheic keratosis.

Roy King1, Robert N Page, Paul B Googe

  • 1Knoxville Dermatopathology Laboratory, Department of Pathology, University of Tennesee Graduate School of Medicine, 315 Erin Drive, Knoxville, TN 37919, USA. rking@labpath.com

The American Journal of Dermatopathology
|May 31, 2003
PubMed
Summary

Desmoplastic seborrheic keratoses can mimic invasive carcinoma due to stromal changes and epithelial nests. Recognizing these features is crucial to avoid misdiagnosis and unnecessary treatment for this common skin condition.

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Area of Science:

  • Dermatopathology
  • Oncology

Background:

  • Seborrheic keratoses (SK) are common benign skin tumors.
  • Desmoplastic changes in SK can histologically resemble invasive squamous cell carcinoma.
  • Accurate diagnosis is essential to prevent overtreatment.

Purpose of the Study:

  • To describe eleven cases of seborrheic keratoses with desmoplastic stroma.
  • To highlight histological features that simulate invasive carcinoma.
  • To emphasize the importance of recognizing these changes to avoid misdiagnosis.

Main Methods:

  • Histopathological examination of eleven SK lesions.
  • Immunohistochemical analysis of epithelial and stromal components.
  • Clinical correlation and differential diagnosis consideration.

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Main Results:

  • Lesions showed exophytic growth, basaloid/squamous cells without atypia, and well-demarcated borders.
  • Desmoplastic stroma with nests/cords of squamous cells mimicked invasion.
  • Immunohistochemistry confirmed epithelial origin (cytokeratin+) and stromal fibroblastic nature (vimentin+).

Conclusions:

  • Desmoplastic changes in seborrheic keratoses can mimic invasive carcinoma.
  • Awareness of these histological patterns is vital for correct diagnosis.
  • Proper identification prevents misdiagnosis and unnecessary aggressive therapy.