Desmoplastic seborrheic keratosis

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Abstract

Eleven cases of seborrheic keratoses with desmoplastic stroma and associated nests and cords of squamous epithelium simulating infiltrating carcinoma are presented. There were 7 males and 4 females ranging in age from 44 to 88 years (mean = 62). Eight cases were on the head and neck, one each on the lower and upper extremity, and one on the pubic area. Clinical diagnoses included seborrheic keratosis, squamous and basal cell carcinoma, and dermal nevus. Histologically, the lesions were characterized by exophytic growth pattern of basaloid and squamous cells, without cytologic atypia, and well-demarcated peripheral borders, typical for that seen in seborrheic keratoses. Squamous eddy formation with parakeratosis and spongiosis was present in all cases. Located within the body of the lesions were irregular nests and cords of squamous cells extending into the surrounding dermis with associated fibroblastic dermal proliferation trapping the epithelial nests, simulating invasive carcinoma. Immunohistochemically, the epithelial nests were cytokeratin positive and HPV negative, and the dermal stromal cells were vimentin positive and factor XIIIa, cytokeratin, and CD34 negative. Adjacent changes of carcinoma, trichilemmoma, verruca, or other adnexal neoplasm were not identified. Seborrheic keratoses may demonstrate desmoplastic changes analogous to that seen in desmoplastic trichilemmomas. Awareness of these changes in seborrheic keratosis will avoid misdiagnosis and excessive therapy.

Original languageEnglish (US)
Pages (from-to)210-214
Number of pages5
JournalAmerican Journal of Dermatopathology
Volume25
Issue number3
DOIs
StatePublished - Jun 1 2003

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Seborrheic Keratosis
Keratins
Carcinoma
Skin
Epithelial Cells
Parakeratosis
Factor XIIIa
Warts
Nevus
Basal Cell Carcinoma
Vimentin
Dermis
Stromal Cells
Diagnostic Errors
Squamous Cell Carcinoma
Lower Extremity
Neck
Epithelium
Head
Growth

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Dermatology

Cite this

Desmoplastic seborrheic keratosis. / King, Roy; Page, Robert; Googe, Paul.

In: American Journal of Dermatopathology, Vol. 25, No. 3, 01.06.2003, p. 210-214.

Research output: Contribution to journalArticle

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