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The inverted follicular keratosis. A surprising variant of seborrheic wart
Abstract:
The pathological features of 29 lesions that had been diagnosed as inverted follicular keratoma have been reviewed. The clinical data suggest that these lesions occur predominantly on the face of middle-aged or elderly man. None were correctly diagnosed before removal. The main histological points noted were the presence of an invaginated type of architecture, foci of keratinization (squamous eddies) and areas of basaloid cells which were arranged haphazardly with mitotic figures (Borst-Jadassohn change). All the histological features seen are also observed in irritated or traumatized seborrheic warts and no evidence was found for the original suggestion that these lesions derive from hair follicles.
Insights
Inverted follicular keratoma (IFK) lesions, predominantly on the face in older men, were reviewed. Histological analysis suggests IFKs resemble irritated seborrheic warts, not hair follicle tumors.
Area of Science:
- Dermatopathology
- Histopathology
Background:
- Inverted follicular keratoma (IFK) is a skin lesion of uncertain histogenesis.
- Previous theories suggested an origin from hair follicles.
Purpose of the Study:
- To review the pathological features of IFK.
- To determine the clinical and histological characteristics of IFK.
- To investigate the potential origin of IFK.
Main Methods:
- Retrospective review of 29 IFK lesions.
- Analysis of clinical data and histopathological findings.
Main Results:
- IFK predominantly affects the face of middle-aged to elderly men.
- None of the lesions were correctly diagnosed pre-operatively.
- Key histological features include invaginated architecture, squamous eddies, and basaloid cells with mitotic figures (Borst-Jadassohn change).
- These features are also present in irritated seborrheic warts.
Conclusions:
- IFK exhibits histological features similar to irritated seborrheic warts.
- There is no evidence to support the hypothesis that IFK originates from hair follicles.
- IFK may represent a reactive or degenerative process rather than a true neoplasm.