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PubMed2000

Inverted follicular keratosis of the vulvar skin: a lesion that can be confused with squamous cell carcinoma.

Although seborrheic keratoses of the vulva are described in textbooks, to our knowledge, inverted follicular keratosis has not been reported. A 27-year-old woman underwent an excisional biopsy for a small lesion of the left labium majus. Squamous cell carcinoma was considered in the clinical differential diagnosis. The initial pathologic diagnosis suggested squamous cell carcinoma in situ, and the consultation diagnosis was superficially invasive squamous cell carcinoma. On pathologic examination, a symmetrical, endophytic, epithelial tumor was observed consisting of a proliferation of basaloid cells with many areas of reactive squamous cells showing numerous squamous eddies, focal reactive nuclear atypia, and occasional mitotic figures. After the pathologic diagnosis of inverted follicular keratosis was made, a history of close perineal shaving and total body tanning was obtained. Because inverted follicular keratosis is postulated to be related to follicular injury, it is likely that the trauma of close shaving is a significant etiologic factor. There is less evidence that ultraviolet ray exposure is of etiologic importance.

Adult↗
PubMed1989

The significance of the Darier-like solar keratosis and acantholytic change in preneoplastic lesions of the epidermis.

Fifty-two lesions of solar keratosis from 40 patients were studied prospectively for the presence of Darier-like changes and acantholysis. Twenty-seven per cent of specimens showed some degree of these changes. The affected lesions tended to be larger and were less common on the hands, but were otherwise clinically indistinguishable from other solar keratoses. Histologically, the specimens with Darier-like changes were significantly thicker and more dysplastic. The autoradiographic labelling index was not different for the lesions with these changes indicating similar cell kinetic characteristics. It is suggested that acantholytic separation of epidermal cells within a solar keratosis may signify that the lesion has a greater invasive potential than a solar keratosis not showing this change.

Acantholysis↗
PubMed2006

Seborrhoeic keratosis and malignancy: collision tumour or malignant transformation?

A retrospective study of 813 histological specimens reported as seborrhoeic keratoses included 43 (5.3%) associated with non-melanoma skin cancer. Intraepidermal carcinoma (squamous cell carcinoma in situ) was the most common of these (36). There were five basal cell carcinomas (one with intraepidermal carcinoma also) and two invasive squamous cell carcinomas. No melanomas were reported. Twenty-seven of the intraepidermal carcinomas appeared to arise within the seborrhoeic keratosis as did one of the invasive squamous cell carcinomas. Of these 28 lesions, the head was the most common site. Fourteen were clinically diagnosed as a non-melanoma skin cancer with only nine clinically felt to be a seborrhoeic keratosis. These lesions may represent malignant transformation within the seborrhoeic keratosis. Twelve specimens reported adjacent dual pathologies, with the trunk and limbs the most common sites. Seven were diagnosed clinically as a skin malignancy, whereas three were thought to be solar keratoses. Clinically, the remaining two were seborrhoeic keratoses. The origin of the malignancy in these cases is less obvious and may represent collision tumours. Three curette specimens could not be assessed for architecture.

Adult↗
PubMed1997

The actinic keratosis. A perspective and update.

BACKGROUND: Actinic keratosis (AK) is a common sun-induced precancerous neoplasm confined to the epidermis. It is the initial manifestation of a continuum of clinical and histologic abnormalities that progresses to invasive squamous cell carcinoma (SCC), a disorder that accounts for thousands of preventable deaths in America each year. OBJECTIVE: The purpose of this work is to describe the actinic keratosis. METHODS: This effort was performed by a literature review and analysis. RESULTS: Like SCCs, the vast majority of AKs are asymptomatic. Although some actinic keratoses may become clinically inapparent, possibly either due to immune rejection or simply having their external surface unknowingly scraped off, an untreated AK represents a potentially curable fatal cancer. CONCLUSIONS: Each AK should be treated before it progresses to invasive squamous cell carcinoma. Destructive modalities such as cryosurgery using liquid nitrogen and electrodesiccation and curettage are the mainstays of therapy. Each case must be individualized. LEARNING OBJECTIVES: After studying this article, participant should be able to: 1. Understand the concept of an actinic keratosis. 2. Learn how to recognize its clinical manifestations. 3. Be aware of the danger it poses as an easily curable papulonodule that may become a fatal cancer.

Carcinoma, Squamous Cell↗
PubMed1994

Ulerythema ophryogenes and keratosis pilaris in a child with monosomy 18p.

We report a 13-year-old boy with deletion of the short arm of chromosome 18 and follicular, partially inflammatory, keratotic papules of the eyebrows, foreskin, and cheeks (ulerythema ophryogenes) as well as the shoulders, upper back, upper arms, and thighs (keratosis pilaris), initially diagnosed as atopic dermatitis. Over 100 patients with this genetic defect have been reported, and the 18p- syndrome is considered one of the most frequently occurring deletion syndromes. However, ulerythema ophryogenes and keratosis pilaris have not been described in any of these patients, although the association of the latter with other genetic abnormalities is well known. Keratosis pilaris is a relatively common genodermatosis of ectodermal origin, frequently occurring with ichthyosis or atopy; concomitance with ulerythema ophryogenes has also been reported. The association of chromosome 18p deletion defect and ulerythema ophryogenes may be helpful in future attempts to localize the gene defect responsible for follicular genokeratoses.

Child↗
PubMed1983

Trichilemmal keratosis (horn): a light and electron microscopic study.

Three cases of trichilemmal keratosis (horn) were light microscopically examined and all showed numbers of U- or V-shaped epidermal proliferations which keratinized in a fashion either identical or similar to trichilemmal keratinization. Electron microscopy revealed both uneven and linear borders between the keratinized and the keratinizing cells with a few keratohyalin droplets, remnants of desmosomes, no marginal band in the horny layer, perinuclear vacuolation, few spherical bodies in the intercellular spaces (ICS) of the upper epidermis, and widening of the ICS of the lower epidermis. A number of electron dense spherical particles, 40-50 nm in diameter, were observed in nuclei of the upper epidermis. This suggests that ultrastructure of trichilemmal keratosis is similar rather to viral warts than to trichilemmal cysts, although there are close similarities between trichilemmal keratosis and cyst.

Adult↗
PubMed1992

Simple epithelial cytokeratin-expression in seborrheic keratosis.

The cytokeratin expression of seborrheic keratosis was studied by means of immunohistochemistry and compared with that of normal human skin. The following findings were obtained in seborrheic keratosis: (1) a partial lack of high molecular weight cytokeratin (#1/68 kD, #10/56.6 kD) in all ten cases examined; (2) the detection of cytokeratin typical for simple epithelia (#8/52.5 kD, #18/45 kD, #19/40 kD) in eight of ten cases; and (3) the detection of cytokeratin #5/58 kD in suprabasal cells in 5 of 10 cases. An immunoelectron-microscopic investigation, using an anti-keratin antibody against cytokeratin #19/40 kD, revealed a whirl-like arrangement of keratin filaments within immunoreactive cells, in contrast to a linear, parallel arrangement in non-immunoreactive cells. Cells known to express cytokeratin typical for simple epithelia, such as sweat gland cells or Merkel cells, were not observed. The altered cytokeratin gene-expression in seborrheic keratosis may be attributable to de-differentiation of tumor cells or potential re-differentiation towards embryonic keratinocytes.

Adult↗
PubMed2003

Atypical keratosis obturans.

Keratosis obturans is a rare condition characterized by the accumulation of desquamated keratin material in the bony portion of the external auditory canal. Classically, it is reported to present with severe otalgia, conductive deafness and global widening of the canal. A case of keratosis obturans is described in which the principal symptom was a metallic taste and the main finding was extensive erosion of the hypotympanum with exposure of the facial nerve and the annulus of the tympanic membrane. This presenting symptom and resorption pattern are atypical of keratosis obturans and have not been documented previously.

Adult↗
PubMed1999

The oligosaccharidic component of the glycoconjugates in lichen planus, granuloma annulare, seborrheic keratosis and plamoplantar keratoderma: lectin histochemical study.

It is well known that cell surface glycoconjugates play an important role in cell proliferation, adhesion and differentiation. The aim of this investigation was to define the changes of the glycoconjugate saccharidic moieties in the epidermis and derma of patients affected by several skin pathologies such as seborrheic keratosis, lichen planus, granuloma annulare and palmoplantaris keratoderma. Bioptical specimens from skin lesions as well as from normal skin were fixed in Carnoy's fluid and routinely processed. The sections were treated with HRP-lectins (PNA, DBA, SBA, WGA, ConA, LTA and UEAI). Cytochemical controls were performed for specificity of lectin-sugar reaction. Some sections were pre-treated with neuraminidase prior to staining with HRP lectins. In comparison with normal human skin, epidermal lectin binding pattern in the considered diseases showed considerable qualitative and quantitative variations. In general, in all the considered pathologies, a lack and/or a decrease in lectin binding at the epidermal layers was observed; among the various diseases, differences in cellular localisation of the sugar residues were also noted. In such respect, an exception was represented by seborrheic keratosis, where the cells of the basal layer showed PNA reactivity, which was absent in the basal layer of the normal skin. Although seborrheic keratosis and lichen planus have been studied by others authors, our findings are not in total accordance concerning lectin binding; this is probably due to the different fixatives employed. Our findings seem to reveal significant changes in keratinocyte glycoconjugate oligosaccharides in the previously mentioned diseases, providing clues to their pathogenesis.

Concanavalin A↗
PubMed2006

[Seborrheic keratosis of conjunctiva: a case report].

CASE REPORT: Pigmented conjunctival lesions are a diagnostic challenge for the clinician. A 37-year-old man presented with a pigmented mass involving the conjunctiva of his right eye. Clinically, a diagnosis of malignant melanoma was made and a wide excision of the tumor was performed. The histopathologic diagnosis was seborrheic keratosis. DISCUSSION: Seborrheic keratosis is a benign lesion which occurs on the eyelids and face of middle-aged and elderly individuals. The occurrence of this lesion on the conjunctiva is rare, however there are 2 cases reported in the world literature. Seborrheic keratosis should be considered in the differential diagnosis of conjunctival pigmented lesions.

Adult↗
PubMed1999

Keratosis pilaris and ulerythema ophryogenes associated with an 18p deletion caused by a Y/18 translocation.

We present a patient with partial monosomy of the short arm of chromosome 18 caused by de novo translocation t(Y;18) and a generalized form of keratosis pilaris (keratosis pilaris affecting the skin follicles of the trunk, limbs and face-ulerythema ophryogenes). Two-color FISH with centromere-specific Y and 18 DNA probes identified the derivative chromosome 18 as a dicentric with breakpoints in p11.2 on both involved chromosomes. The patient had another normal Y chromosome. This is a third report the presence of a chromosome 18p deletion (and first case of a translocation involving 18p and a sex chromosome) with this genodermatosis. Our data suggest that the short arm of chromosome 18 is a candidate region for a gene causing keratosis pilaris. Unmasking of a recessive mutation at the disease locus by deletion of the wild type allele could be the cause of the recessive genodermatosis.

Adolescent↗
PubMed2000

Actinic keratosis is squamous cell carcinoma.

BACKGROUND: The prevalence of nonmelanoma skin cancer in the United States is alarming. It can be most appropriately treated if the earliest manifestation of cutaneous squamous cell carcinoma is recognized. METHODS: Clinical, histologic, and molecular biology, considerations were reviewed to determine whether actinic keratosis is the earliest clinical manifestation of cutaneous squamous cell carcinoma. RESULTS: The clinical, histologic, and molecular parameters of actinic keratosis are those of squamous cell carcinoma. CONCLUSION: Actinic keratosis does not transform, convert, or progress into cutaneous squamous cell carcinoma but is the earliest clinically recognizable manifestation of this malignancy.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Actinic keratosis--a histoenzymological study.

Actinic keratosis or senile keratosis is the most frequent premalign epithelial lesion that occurs in the elderly with a history of prolonged and intense exposure to the UV radiation and with an inborn susceptibility. Although the genetics and risk factors are clear nowadays, the histogenesis of this lesion is still under study. The histoenzymologic tests (such as those that demonstrate the ATP-ase and SDH-ase activity) are very useful for early detection of the structural and biochemical changes within the actinic keratosis lesion.

Adenosine Triphosphate↗
PubMed2000

[16 cases of laryngeal keratosis treated with viaminati].

OBJECTIVE: To investigate the treatment efficient of viaminati on the laryngeal keratosis. METHOD: All 16 cases of laryngeal keratosis took viaminati. RESULT: 15 cases were recovered. 1 case was developed cancer. CONCLUSION: Viaminati is effective in treating laryngeal keratosis and has not obvious side-effect.

Adult↗
PubMed1980

Benign lichenoid keratosis.

Forty patients (39 white, one Oriental) had an isolated asymptomatic lichenoid keratotic lesion varying from bright red to violaceous to brown. The clinical diagnoses included basal cell carcinoma, actinic keratosis, Bowen's disease, and seborrheic keratosis. Histologically, lichenoid features prevailed, often indistinguishable from those of lichen planus. Although the majority of lesions occurred in sun-exposed skin and showed histologic evidence of solar elastosis, changes typical of carcinoma in situ were absent. The correct pathologic diagnosis of benign lichenoid keratosis was initially made in only seven cases.

Adult↗
PubMed1996

Radiation keratosis associated with exposure to a gold ring.

A radiation keratosis occurred in a woman who wore a radioactive gold ring forty-three years ago. Clinicians should be aware that not all "warty lesions" on the hands are actinic keratosis, seborrheic keratosis, or warts. Radioactive gold rings still exist. Diagnosis requires a high index of suspicion, since patients may no longer be wearing the offending ring.

Aged↗
PubMed1997

Induction of cancer, actinic keratosis, and specific p53 mutations by UVB light in human skin maintained in severe combined immunodeficient mice.

To study the mechanism and risk of human skin cancer from solar light, we exposed human skin transplanted to severe combined immunodeficient mice to daily doses of UVB for periods of approximately 2 years. We have succeeded for the first time in inducing cancer and solar (actinic) keratosis in human skin by UVB. Of 18 normal skins exposed to doses of 7.3 x 10(5) to 1.8 x 10(6) J/m2, 14 actinic keratoses (77.8%) and 3 squamous cell carcinomas (16.7%) developed, whereas neither actinic keratosis nor cancer was observed in 15 human skins not exposed to UVB. Each human skin showed a different susceptibility, and skins sensitive for actinic keratosis were also sensitive for cancer induction. Among p53 mutations at various sites, mutation at codon 242 (C TGC --> C CGC; Cys --> Arg) was specifically observed in both skin cancers and actinic keratoses. Furthermore, double or triple mutations were induced in all UVB-induced skin cancers and in three of eight actinic keratoses. Most of the mutations (17 of 20) occurred at dipyrimidine sites.

Animals↗
PubMed1998

Lenticular acral keratosis in washerwomen.

BACKGROUND: In 1952, a Brazilian dermatologist, Oswaldo Costa, described a dermatosis characterized by accentuation of the cutaneous folds on the knuckles of both hands and small horny papules on the thenar eminences, posterior surface of the wrists, and the interdigital space between thumb and index finger; he called this entity acrokeratoelastoidosis. Other similar entities, such as focal acral hyperkeratosis and marginal keratoelastoidosis, have been described. The features of the different types of lenticular acral keratosis are discussed. MATERIALS AND METHODS: Fifteen patients with lenticular acral keratosis and five controls were studied clinically and pathologically. The skin biopsies were processed for light and transmission electron microscopy. The clinical data were reviewed, and the following variables were recorded: age, sex, distribution and morphology of the lesions, history of exposure to sunlight and objective evidence of photodamage, familial incidence, occupation and hobbies, time of evolution, and response to previous treatments. The results were compared with samples taken at autopsy from five women without dermatoses. RESULTS: All patients were women, with flat, keratotic papules located on the transition between the dorsal and volar surfaces of the fingers and hands. Histologically, there was an increased amount of elastic fibers, which were coarse and tortuous, and appeared to be interrupted in some areas. In contrast, there were sparse, thin fibers in the mid and deep dermis in the skin of controls. Transmission electron microscopy of these papules showed enlarged, thickened elastic fibers, with deposits of electron-dense, coarse clumps. CONCLUSIONS: Our cases do not seem to correspond to any of the three entities which are manifested clinically by acral keratotic plaques. All of these women washed clothes by hand on a stone washboard for many hours every day. As there is no clinical or histologic evidence of actinic damage, chronic trauma seems to be the cause of the dermatosis in this type of patient. We propose the term "occupational lenticular acral keratosis" for our cases.

Acrodermatitis↗