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Seborrheic keratosis with focal acantholysis.

A case of a 70-year-old man with several dome-shaped tumors with acantholysis was reported. The histopathological findings of these black-brownish colored tumors on the back were compatible with seborrheic keratosis, consisting of basaloid and squamoid cells. Although three cases reported by Tagami et al. (1978) and Uchiyama et al. (1986) showed intraepidermal epithelioma-like tumor nests in the acanthotic lesions, our case was thought to correspond to another variant of seborrheic keratosis with acantholysis.

Acantholysis↗

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.

Dermatitis, Seborrheic↗

Eruptive seborrheic keratoses associated with erythrodermic pityriasis rubra pilaris. Possible role of retinoid therapy.

A 74-year-old female patient with an erythrodermic pityriasis rubra pilaris developed multiple seborrheic keratoses during the early stage of the skin disorder. There was no evidence of an underlying internal malignancy. Initially, the patient was treated with etretinate. The seborrheic keratoses all faded away during the next 3-4 months without any specific treatment. The possible role of retinoid treatment in the resolution of seborrheic keratoses is discussed.

Aged↗

The sign of Leser-Trélat: does it exist?

The sign of Leser-Trélat is usually regarded as a reliable cutaneous marker of internal malignancy. We have reviewed the literature and conclude that the evidence for a causal relation between eruptive seborrheic keratoses and cancer is meager.

Dermatitis, Seborrheic↗

Histologic changes in seborrheic keratoses after rubbing.

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.

Biopsy↗