Trichilemmal keratinization in seborrheic keratoses

In 33 of 112 seborrheic keratoses reviewed histologically, a keratinization process was observed, which was identical with or showed marked similarity to, trichilemmal keratinization (TK). This type of keratinization took place more frequently in lesions which were pruritic and in those located on the extremities. Histologically, the change was observed in the bottoms of pseudocysts and crypts, in areas showing evidence of inflammation, such as exocytosis, spongiosis and squamous eddy or whorl formation. No relationship was found between the presence of TK or TK-like keratinization and the various histologic types of seborrheic keratoses. It is concluded that a process which can not be distinguished from TK microscopically may occur frequently in seborrheic keratoses as a result of inflammation.