Seborrheic keratosis in an uncommon location: A case study of auricular involvement

Seborrheic keratosis (SK) is a benign neoplasm frequently observed on the head, neck, trunk, and extremities, with infrequent occurrences in the auricle and external auditory canal. This condition typically manifests as multiple small lesions, although it can occasionally present as large solitary tumors, particularly in older individuals.

We present a case involving a 74-year-old male who exhibited a pruritic, progressively enlarging papillomatous lesion on the left auricle, which had developed over a span of eight years. Upon physical examination, a 1.5 × 1.5 cm brownish, verrucous lesion was identified. Surgical excision was conducted, utilizing a graft from the posterior auricle to repair the resultant defect, and histopathological analysis subsequently confirmed the diagnosis of seborrheic keratosis.

Seborrheic keratosis is characterized by a variety of histological subtypes and necessitates differentiation from other benign and malignant skin conditions. While generally benign, surgical intervention is often warranted to exclude malignancy and for cosmetic considerations. The rarity of SK in the auricle underscores the necessity for meticulous evaluation and management.

This case highlights the atypical presentation of seborrheic keratosis in the auricle, with only 18 cases documented in the literature as of 2023. Our surgical approach effectively addressed the lesion while ensuring differentiation from malignant conditions. Continuous follow-up is crucial to monitor for potential recurrence or the emergence of associated malignancies.