High expression level of homocitrulline is correlated with seborrheic keratosis and skin aging

Abstract Backgroud Homocitrulline (Hcit), is involved in the pathological processes of some diseases. However, the role and function of Hcit (CBL) in human skin remains largely obscure. Objective To investigate the correlation of the level of Hcit in seborrheic keratosis, skin aging, and its clinical significance. Methods Immunohistochemistry was used to analyze the level of Hcit in skin lesions of seborrheic keratosis (SK), unaffected skin (distant 0.5 centimeters from SK lesion), and normal skin of healthy subjects in the control group. ELISA test was used to detect the serum level of CBL in SK patients and healthy subjects of different ages. Results Hcit was mainly localized in the nucleus of epidermal cells. In healthy control skin, the expression of Hcit increased with age and showed a positive correlation with age (the correlation coefficient was 0.806, p = 0.0002). The expressional level of Hcit in SK lesions was higher than that in healthy control skin (Z = −3.703, p = 0.0002). The serum level of CBL in healthy subjects and in SK patients increased with age (the correlation coefficient were 0.5763, p = 0.0032; 0.682, p = 0.004. respectively). The serum level of CBL in SK patients was higher than that in healthy subjects (Z = −2.19, p = 0.030). Study limitations The small serum sample size in the study. Conclusion The high expressional level of Hcit is correlated with seborrheic keratosis and skin aging. HCit may be one of the potential biomarkers of skin aging.

Queratosis seborreica: variante clonal. reporte de un caso / Seborrheic clonal keratosis. case report

RESUMEN Las queratosis seborreicas son tumores benignos muy frecuentes en la práctica diaria y la mayoría de los pacientes desarrollarán alguna en el transcurso de la vida. La variante clonal es una forma histopatológica rara y su importancia radica en la necesidad de realizar diagnóstico diferencial con otras patologías de mayor relevancia como carcinoma basocelular e incluso melanoma. Se presenta el caso clínico de una paciente de 76 años con una lesión histológicamente compatible con la variante clonal de la queratosis seborreica.

SUMMARY Seborrheic keratoses are benign tumors that are very common in daily dermatology practice and most patients will develop some over the course of their lives. The clonal variant is a rare histopathological form and its importance lies in the need to perform a differential diagnosis with other pathologies of greater relevance such as basal cell carcinoma and even malignant melanoma. We present the clinical case of a 76-year-old female patient with a diagnosis of clonal seborrheic keratosis.

Melanoacanthoma: a potential pitfall of reflectance confocal microscopy

Abstract Melanoacanthoma is a rare variant of seborrheic keratosis, which is notable for dark pigmentation and fast radial growth, making it difficult to distinguish from melanoma. Histologically, it is characterized by proliferation of keratinocytes and dendritic melanocytes. The authors report a scalp lesion, fast growing, suspected by dermoscopy and confocal microscopy examination, with dendritic cells distributed throughout the lesion. Based on these findings, it was not possible to classify this lesion as clearly benign, so it was excised. Histopathologic evaluation and immunostain were consistent with melanoacanthoma.

Signo de leser-trélat, signo paraneoplásico en cáncer de mama metastásico: presentación de caso / Leser-trélat sign: paraneoplastic sign in metastatic breast cancer, case presentation / Sinal de leser-trélat: sinal paraneoplásico em câncer de mama metastático, apresentação de caso

Resumen El signo de Leser-Trélat es una erupción súbita y de veloz crecimiento de cuantiosas queratosis seborreicas secundarias a una neoplasia interna. Estas pueden estar relacionadas con prurito y acantosis nigricans. Las neoplasias asociadas frecuentemente al signo de Leser-Trélat son los adenocarcinomas gástricos, de colon y mama, representado en menor cantidad por linfomas, carcinoma de células escamosas y malignidades hematológicas. Siendo el signo de Leser-Trélat una dermatosis paraneoplásica infrecuente, se presenta un caso de una paciente de 76 años con cáncer de mama avanzado asociado a este signo.

Abstract The Leser-Trelat sign is a sudden and rapid growth eruption of large seborrheic keratoses secondary to an internal neoplasm. These may be related to pruritus and acanthosis nigricans. The neoplasms frequently associated with the Leser-Trélat sign are gastric, colon and breast adenocarcinomas, represented to a lesser extent by lymphomas, squamous cell carcinoma and hematological malignancies. As the Leser-Trélat sign is an uncommon paraneoplastic dermatosis, a case of a 76-year-old patient with advanced breast cancer associated with this sign is presented.

Resumo O sinal de Leser-Trélat é uma erupção súbita e de veloz crescimento de múltiplas ceratoses seborreicas secundárias a uma neoplasia interna. Estas podem estar relacionadas com prurido e acantose nigricans. As neoplasias associadas frequentemente ao sinal de Leser-Trélat são os adenocarcinomas gástricos, de colón e mama, representado em menor quantidade por linfomas, carcinoma de células escamosas e malignidades hematológicas. Sendo o sinal de Leser-Trélat uma dermatose paraneoplásica infrequente, apresenta-se um caso de uma paciente de 76 anos com câncer de mama avançado associado a esse sinal.

Pigmented Eccrine Poroma Mimicking Seborrheic Keratosis / 대한피부과학회지

No abstract available.

Queratosis seborreica eruptiva y su asociación con cáncer gastrointestinal. Un estudio de casos y controles / Eruptive seborrheic keratosis and its association with gastrointestinal cancer. A case-control study

Resumen Introducción: se ha propuesto la existencia de asociación entre queratosis seborreica eruptiva y algunas neoplasias malignas. Sin embargo, la evidencia acerca de esto es pobre: tres estudios europeos de casos y controles cuyos resultados no la apoyan. El objetivo del estudio es evaluar en población colombiana la existencia o no de esta asociación. Material y métodos: estudio de 130 casos y 260 controles pareados por edad y sexo en mayores de 18 años entre pacientes con cáncer gastrointestinal o pancreatobiliar (casos) u hospitalizados por otras razones no oncológicas (controles) en el Hospital Universitario de Santander, Bucaramanga (Colombia). A todos los pacientes se les realizó examen cutáneo minucioso, incluyendo dermatoscopia, para identificar la presencia y tiempo de evolución de queratosis seborreica en zonas cubiertas por ropa. Resultados: la prevalencia de queratosis seborreica entre los casos fue 26.9% (IC95% 19.5-35.4) y de 15.4% (IC95% 11.2-20.4) entre los controles (OR 1.94, IC95% 1.17-3.19). Siete pacientes con cáncer presentaban la queratosis seborreica en los seis meses previos al diagnóstico de la neoplasia (5.3%, IC95% 2.2-10.8) frente a ninguno entre los pacientes control (0.0%, IC95% 0.0-1.4; p<0.001); tres de ellos tenían 20 o más lesiones de menos de seis meses de aparición (2.3% de los casos, IC95% 0.5-6.6) frente a ninguno entre los controles (p=0.014). Discusión: este estudio trata de subsanar las debilidades de los únicos tres estudios previos que exploran la asociación entre queratoris seborreica y cáncer mediante la rigurosa selección de pacientes, la inclusión de pacientes con cáncer de un solo sistema corporal y un proceso estricto para evaluar las lesiones cutáneas con dermatoscopia. Esto permite concluir que en pacientes colombianos con cáncer gastrointestinal hay mayor frecuencia de queratosis seborreica y de queratoris seborreica eruptiva que en personas de igual edad y sexo sin cáncer. (Acta Med Colomb 2017; 42: 224-229).

Abstract Introduction: the association between eruptive seborrhoeic keratosis and some malignant neoplasms has been proposed. However, the evidence about this is poor: three European case-control studies whose results do not support it. The objective of the study is to evaluate the existence or not of this association in the Colombian population. Material and methods: study of 130 cases and 260 matched controls for age and sex in patients over 18 years of age among patients with gastrointestinal or pancreatobiliary cancer (cases) or hospitalized for other non-oncological reasons (controls) at the University Hospital of Santander, Bucaramanga (Colombia). All patients underwent meticulous skin examination including dermatoscopy, to identify the presence and time of evolution of seborrheic keratosis in areas covered by clothing. Results: the prevalence of seborrheic keratosis among the cases was 26.9% (95% CI 19.5-35.4) and 15.4% (95% CI 11.2-20.4) among the controls (OR 1.94, 95% CI 1.17-3.19). Seven patients with cancer presented seborrheic keratosis in the six months prior to the diagnosis of neoplasia (5.3%, 95% CI 2.2-10.8) compared to none among control patients (0.0%, 95% CI 0.0-1.4, p <0.001); three of them had 20 or more lesions less than six months of onset (2.3% of cases, 95% CI 0.5-6.6) compared to none among controls (p = 0.014). Discussion: this study tries to correct the weaknesses of the only three previous studies that explore the association between seborrheic keratosis and cancer by rigorous selection of patients, the inclusion of cancer patients from a single body system and a strict process to evaluate the skin lesions with dermatoscopy. This allows concluding that in Colombian patients with gastrointestinal cancer there is a greater frequency of seborrheic keratosis and eruptive seborrheic keratosis than in people of the same age and sex without cancer. (Acta Med Colomb 2017; 42: 224-229).

Clinical and Histopathological Investigation of Seborrheic Keratosis

BACKGROUND: Seborrheic keratosis (SK) is one of the most common epidermal tumors of the skin. However, only a few large-scale clinicohistopathological investigations have been conducted on SK or on the possible correlation between histopathological SK subtype and location. OBJECTIVE: The aim of this study was to analyze the clinical and histopathological features of a relatively large number of cases of diagnosed SK. METHODS: Two hundred and seventy-one pathology slides of skin tissue from patients with clinically diagnosed SK and 206 cases of biopsy-proven SK were analyzed. The biopsy-proven cases of SK were assessed for histopathological subclassification. The demographic, clinical, and histopathological data of the patients were collected for analysis of associated factors. RESULTS: The most frequent histopathological subtype was the acanthotic type, followed by mixed, hyperkeratotic, melanoacanthoma, clonal, irritated, and adenoid types; an unexpectedly high percentage (9.2%) of the melanoacanthoma variant was observed. The adenoid type was more common in sun-exposed sites than in sun-protected sites (p=0.028). Premalignant and malignant entities together represented almost one-quarter (24.2%) of the clinicopathological mismatch cases (i.e., mismatch between the clinical and histopathological diagnoses). Regarding the location of SK development, the frequency of mismatch for the sun-exposed areas was significantly higher than that for sun-protected areas (p=0.043). CONCLUSION: The adenoid type was more common in sun-exposed sites. Biopsy sampling should be performed for lesions situated in sun-exposed areas to exclude other premalignant or malignant diseases.

Clinical and Pathological Analysis on 286 Cases of Seborrheic Keratosis / 昆明医科大学学报

Objective To explore the clinical and histopathological characteristics and the diagnostic status of seborrheic keratosis (SK) Methods The clinical and pathological data of 286 cases were analyzed retrospectively.Results Among the 286 patients,the elderly patients accounted for the majority and more males were diagnosed with SK than females.The lesions were found among 46.2％ of patients in the exposure sites,such as face and neck.The most frequent types were hyperkeratosis and acanthosis.The clinical diagnosis consisted with pathologic diagnosis in 152 cases.The clinical misdiagnosis rate was 36.7％.Conclusion SK is related to gender,age,and sunlight.Histopathological examination is important in the diagnosis and differential diagnosis of SK.

Malignant Hidroacanthoma Simplex with Seborrheic Keratosis / 대한피부과학회지

No abstract available.

Composite Tumor Associating Trichoblastoma and Seborrheic Keratosis

Seborrheic keratosis is a common benign epidermal tumor histologically composed of basaloid and squamous cells. It mainly occurs on the face, scalp, and trunk, and presents clinically as a well-circumscribed, brownish to black papule, nodule, or plaque. Trichoblastoma is a relatively rare benign, slow-growing tumor showing differentiation toward the primitive hair follicle. It clinically manifests as a solitary, skin to erythematous colored, well-circumscribed dermal nodule located predominantly on the head and neck with a predilection for the scalp. Histologically, a well-demarcated mass of follicular germinative cells that show various degrees of differentiation, arranged in lobules, sheets, and nests, is located in the dermis or subcutaneous fat layer. We report the case of a 28-year-old female patient with a solitary, 2.0x4.0-cm black plaque with a 0.7-cm skin-colored nodule on the scalp. Histologically, the entire black plaque had prominent hyperkeratosis, acanthosis, and papillomatosis with horn cysts. The central nodule showed well-circumscribed, various-sized dermal tumor lobules without a connection to the overlying epidermis. The lobular aggregation was composed of numerous basaloid epithelial nests and multiple primitive papillary structures with distinct peripheral palisading of nuclei. According to these findings, the scalp lesion was diagnosed as a composite tumor associating trichoblastoma and seborrheic keratosis.

Composite Tumor Associating Trichoblastoma and Seborrheic Keratosis

Seborrheic keratosis is a common benign epidermal tumor histologically composed of basaloid and squamous cells. It mainly occurs on the face, scalp, and trunk, and presents clinically as a well-circumscribed, brownish to black papule, nodule, or plaque. Trichoblastoma is a relatively rare benign, slow-growing tumor showing differentiation toward the primitive hair follicle. It clinically manifests as a solitary, skin to erythematous colored, well-circumscribed dermal nodule located predominantly on the head and neck with a predilection for the scalp. Histologically, a well-demarcated mass of follicular germinative cells that show various degrees of differentiation, arranged in lobules, sheets, and nests, is located in the dermis or subcutaneous fat layer. We report the case of a 28-year-old female patient with a solitary, 2.0x4.0-cm black plaque with a 0.7-cm skin-colored nodule on the scalp. Histologically, the entire black plaque had prominent hyperkeratosis, acanthosis, and papillomatosis with horn cysts. The central nodule showed well-circumscribed, various-sized dermal tumor lobules without a connection to the overlying epidermis. The lobular aggregation was composed of numerous basaloid epithelial nests and multiple primitive papillary structures with distinct peripheral palisading of nuclei. According to these findings, the scalp lesion was diagnosed as a composite tumor associating trichoblastoma and seborrheic keratosis.

El signo de Leser-Trélat ¿Un predictor de neoplasias útil en clínica? / The Leser-Trélat sign A useful predictor of neoplasms in clinic?

Propósito: el signo de Leser-Trélat conjuga la presencia simultánea de queratosis seborreica eruptiva con una neoplasia maligna, pero existen publicaciones de pacientes con queratosis con o sin la neoplasia. Se buscó establecer si hay evidencia sobre esta asociación para considerar la potencialidad de la aparición de tales lesiones dermatológicas como un hallazgo precoz de neoplasias malignas. Fuente de datos: revisión sistemática de la literatura ubicada en Medline, Cochrane, Lilacs, Scholar Gloogle e Imbiomed. Selección de estudios: se evaluaron todos los artículos afines a queratosis seborreica eruptiva y cáncer, sin límite en edad, sexo, tipo de artículo o idioma. Extracción de datos: se leyeron de 668 resúmenes y se revisaron 120 artículos completos, 66 utilizados en este informe. Resultados: la evidencia que apoya la asociación entre queratosis seborreica súbita y cáncer es pobre: sólo existen cuatro estudios de casos y controles cuyos resultados no apoyan esta asociación. Conclusiones: la gran mayoría de las publicaciones son producto del hallazgo al azar de las dos entidades y no producto de la búsqueda sistemática de una de ellas cuando aparece la otra, lo que refleja una especie de sesgo de selección a la hora de publicar dichos casos.

Purpose: the sign of Leser-Trélat conjugates the simultaneous presence of eruptive seborrheic keratoses with a malignancy, but there are reports of patients with keratosis with or without neoplasia. The establishment of whether there is evidence for this association to consider the potential for the occurrence of such skin lesions as an early finding of malignant neoplasms was sought. Data Sources: a systematic review of the literature located on Medline, Cochrane, Lilacs, Schoolar Google and Imbiomed. Study Selection: all articles related to eruptive seborrheic keratosis and cancer, with no limit on age, sex, type of article or language were evaluated. Data Extraction: 668 abstracts were read and 120 full articles were reviewed, 66 used in this report. Results: the evidence supporting the association between sudden seborrheic keratosis and cancer is poor: there are only four case-control studies whose results do not support this association. Conclusions: the vast majority of publications are the product of chance finding of the two entities and not the result of a systematic search of one of them when the other appears, reflecting a kind of selection bias in publishing such cases.

Leser-Trelat Sign Associated with Malignant Melanoma / 대한피부과학회지

Leser-Trelat sign is a rare paraneoplastic dermatosis that is characterized by the eruptive and rapid development of multiple seborrheic keratosis that coincides with an internal malignancy. Eruptive seborrheic keratosis can be pruritic and appear in a "Christmas-tree pattern." This sign occurs in association with a number of cancers, such as adenocarcinoma of the gastrointestinal tract and various lymphoproliferative disorders. However, Leser-Trelat sign associated with a malignant melanoma is very rare. A 58-year-old male patient presented with an asymptomatic black mass on the penile orifice and patch on the glans penis. He complained of gross hematuria. At the same time, he developed asymptomatic multiple brown papules and plaques on the back. The histopathologic findings of the glans and back lesions were consistent with malignant melanoma and seborrheic keratosis, respectively. Here, we describe a rare case of Leser-Trelat sign associated with malignant melanoma.

Bowen Disease Arising in Recurred Seborrheic Keratosis after Incomplete Removal / 대한피부과학회지

Seborrheic keratosis is a common benign epithelial tumor which occurs primarily on sun-exposed area, and is occasionally associated with several malignant or premalignant conditions. Among these malignant or premalignant conditions, Bowen disease and basal cell carcinoma are common, but still it is not clear whether these malignancies arise incidentally with seborrheic keratosis or malignant transformation has occurred. We herein report a case of Bowen disease with seborrheic keratosis on the inguinal area where prior seborrheic keratosis had recurred after incomplete removal.

A Case of Dermatosis Papulosa Nigra / 대한피부과학회지

No abstract available.

A Clinicohistopathological Study on the Lesion Resembling Seborrheic Keratoses of the Face / 대한피부과학회지

BACKGROUND: The most of typical seborrheic keratoses (SKs) can be clinically differentiated with ease from other dermatoses. However, its differential diagnosis can sometimes be difficult and recently reported cases clinically suggest that SKs with the skin biopsy result being some other diseases can bring on the need for further evaluations. OBJECTIVE: The aim of this study is to examine the diagnostic yield in submitting clinically diagnosed SKs which showed single discoid lesions of the face for routine microscopic examinations. METHODS: We conducted a retrospective review of cases for histological examinations with a clinical diagnosis of SKs or with a differential diagnosis that includes SKs which shows single discoid lesion of the face. A total of 94 pathology reports containing a diagnosis of SKs in the clinical information field were identified. The accuracy of the clinical diagnosis and clinic histopathological correlations were studied. RESULTS: In this study, 45.7% of patients was clinically assumed to have SKs but turned out to be some other diseases according to the histopathology test results - a total of 19 cases (44.2%) with some considered to be precancerous (actinic keratosis 25.6%, benign lichenoid keratosis 16.3% or cancerous (basal cell carcinoma 9.3%, squamous cell carcinoma 4.7%). CONCLUSION: Lesions suggested to be SKs need more examinations and lesions of atypical clinical appearances which cannot completely exclude the possibility of precancerous or malignant lesions are strongly recommended for skin biopsies.

Seborrheic Keratosis of Areola Treated with Topical Calcipotriol Ointment / 대한피부과학회지

A synthetic analogue of calcitriol (1,25-dihydroxymitamin D3), has shown immunomodulatory effects as well as induction of cell differentiation and inhibition of cell proliferation. This agent has been widely used for psoriasis. We report a case of seborrheic keratosis of the left areola in a 33-year-old female who was treated with calcipotriol ointment. Because of the lesion's location and shape, it was difficult to try ablative methods. However, complete disappearance of the lesion was observed after 6 weeks of topical calcipotriol application. This case suggests that the calcipotriol ointment is effective in the treatment of seborrheic keratosis.

Histologic and Dermoscopic Findings of Clear Cell Acanthosis in Seborrheic Keratosis / 대한피부과학회지

Clear cell acanthosis is a reaction pattern of the epidermis that can be observed as the chief histopathologic finding in clear cell acanthoma and as a focal change in other epidermal lesions, such as verruca vulgaris and seborrheic keratosis. Dermoscopy is a useful noninvasive tool that permits the visualization of key vascular structures that are usually not visible to the naked eye. A 63-year-old Korean man was presented with 2 year of a well-circumscribed, dome-shaped nodule on the nipple. Our patient represents patterns of both a clear cell acanthoma and a seborrheic keratosis on dermoscopic and histopathologic finding, but, notably, on dermoscopy vascular structures were more irregular linear distribution than classic clear cell acanthoma and different from dotted vessels shown in psoriasis. In this report, we describe a case of clear cell acanthosis in seborrheic keratosis for whom dermoscopy was used as a valuable diagnostic tool.

Seborrheic Keratosis of Auricle: A Case Report and Literature Review / 대한이비인후과학회지

Seborrheic keratosis (SK) is a common benign lesion that develops from the proliferation of epidermal cells. Since SK usually occurs on the face, extremities, and upper trunk of the elderly, the finding of this lesion on the auricle is rare. Given the rarity of SK lesions of the auricle and the lack of familiarity with its presentation, otolaryngologists have difficulty diagnosing SK. Authors experienced a case of solitary SK that originated from the auricle in a 65-year-old man. We present this case with a review of the literature.

Clinical and Histopathologic Study of Seborrheic Keratosis / 대한피부과학회지

BACKGROUND: Although seborrheic keratosis is one of the most common epidermal tumors, there are only rare studies on the clinicohistopathologic features of seborrheic keratosis in Korea. The majority of cases of typical seborrheic keratosis can be clinically differentiated with ease from other dermatoses such as melanocytic nevi, lentigo, basal cell carcinoma and melanoma. However, its differential diagnosis can sometimes be difficult. OBJECTIVE: This study was designed to investigate the clincohistopathologic characteristics of seborrheic keratosis, the frequency of biopsy and the accuracy of making the clinical diagnosis, as well as to analyze the cases where there is a mismatch between the clinical diagnosis and the histological diagnosis. METHODS: We conducted a retrospective study and we searched for patients who were clinically diagnosed as having seborrheic keratosis between January 2000 and December 2008. The search found 1,248 patients and the patients were divided into two groups: a non-biopsy group (n=891) and a biopsy group (n=357). The clinical features, including age, gender, the anatomic site of lesion and the treatment method, were investigated in each group. In addition, the frequency of biopsy, the accuracy of the clinical diagnosis and the histopathological features were studied in the biopsy group. RESULTS: Between the two groups, we found that the clinical features, including the proportions between the involved body sites, such as trunk/face, and the treatment methods were different. However, these differences might be partly attributed to the clinical decisions such as the frequency of performing biopsy for making the differential diagnosis of skin malignancy. In both groups, the most frequent age period was in the seventh decade and the most common anatomical site was the face. Only one-third of patients who were clinically diagnosed as having seborrheic keratosis received biopsy for histopathologic confirmation and the lesions were mostly located on the face. The clinical diagnosis matched the histological diagnosis in 282/357 (79.0%) patients. In 75 patients who revealed a mismatch between the clinical and histological diagnosis, the skin lesion most frequently involved the face (57.3%) and the most common final diagnosis was basal cell carcinoma (13.3%). The frequency of a mismatch for the sun-exposed lesion was significantly higher than that of the non-sun exposed lesion (p=0.035). CONCLUSION: We present the clinical and histopathological features of seborrheic keratosis. If the lesion is presented with an atypical appearance or it located on a sun-exposed area and so it requires a differential diagnosis from other premalignant diseases or cutaneous malignancies, then we should perform a biopsy to make the differential diagnosis.