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Histologic changes in seborrheic keratoses after rubbing
Abstract:
Seborrheic keratoses in five patients were rubbed and biopsied at varying intervals after injury. Microscopic examination revealed acute and chronic patterns of histologic change. Hemorrhage, hyalinization of dermal papillae, and necrosis of epithelial tips were conspicuous early changes. Specimens taken more than 48 h after rubbing showed a spectrum of changes which included: loss of epithelial mass, expansion and interconnection of keratin cysts, thinning of the epithelium, proliferation of epithelial strands from the residual epithelium, increase in size of epithelial cells, and evidence of hair follicle relationships including trichostasis spinulosa and, in one specimen, hair germ proliferation. Dermal lymphocytic infiltration was variable and only rarely involved the epithelium. These observations demonstrate a patterned response of the seborrheic keratosis to trauma, and also indicate a relationship between seborrheic keratosis and the hair follicle.
Insights
Trauma induces a patterned histologic response in seborrheic keratoses, revealing early changes like hemorrhage and later alterations including epithelial changes and hair follicle associations. This study highlights the skin condition's reaction to injury.
Area of Science:
- Dermatology
- Histopathology
- Skin Biology
Background:
- Seborrheic keratoses are common benign epidermal tumors.
- The response of seborrheic keratoses to physical trauma is not well-characterized.
- Understanding these responses can provide insights into skin lesion dynamics.
Purpose of the Study:
- To investigate the histologic changes in seborrheic keratoses following induced trauma.
- To identify early and late patterns of cellular and tissue response.
- To explore potential relationships between seborrheic keratoses and hair follicles.
Main Methods:
- Five patients with seborrheic keratoses underwent controlled rubbing (trauma).
- Biopsies were collected at various time points post-trauma.
- Histologic examination analyzed acute and chronic changes.
Main Results:
- Early changes (within 48h) included hemorrhage, dermal papillae hyalinization, and epithelial necrosis.
- Later changes involved epithelial thinning, keratin cyst expansion, and proliferation of epithelial strands.
- Evidence of hair follicle involvement, such as trichostasis spinulosa and hair germ proliferation, was observed.
Conclusions:
- Seborrheic keratoses exhibit a distinct, patterned histologic response to trauma.
- The findings suggest a significant relationship between seborrheic keratoses and adjacent hair follicles.
- Trauma can alter the histologic appearance of seborrheic keratoses, mimicking other conditions.