Dermatoscopic and morphological features of some clinical variants of seborrheic keratosis

Objective — to determine medical tactics, trace the relationship and supplement the correlation information between clinical manifestations, dermatoscopic patterns and histological picture of typical and flat variants of seborrheic keratosis (SK).Materials and methods. The studies were conducted in Zaporizhzhya Regional Dermatovenerological Clinical Hospital of Zaporizhzhya Regional Council. 20 persons with seborrheic keratosis were monitored — 14 (70 %) women and 6 (30 %) men aged 41 to 87. The screening included a general, dermatoscopic and pathomorphological examination of the patient.Results and discussion. More often, lesions were localized on the skin of the body — in 10 persons, on face and scalp — in 5, on lateral neck — in 3, less often on upper limbs — in 2 patients. Fitzpatrick’s І phototype was detected in 3 (15 %) persons, ІІ phototype — in 13 (65 %), ІІІ phototype — in 4, which equals to 20 %. Histologically, the acanthotic type of seborrheic keratosis was identified in 14 (70 %), papillomatous and reticular in — 5 and 1 patients, respectively. The dermatoscopic picture of the acanthotic variant is represented by the following criteria: milia­like cysts— in 10 cases, comedo­like openings— in 4, «convoluted cerebriform pattern» — in 5, «moth­eaten» border — in 2, verrucous surface — in 1, papillomatous SK with verrucous, papillary surface — in 1, keratoma with patterns of «finger print» type — in 3 cases. The reticular (adenoid) variant is represented by a symmetrical lesion of dark brown color and round shape up to 0.5 cm in diameter with moth-­eaten borders and milia­-like cysts around the periphery. Conclusions. The variability of the clinical, dermatoscopic, and pathomorphological manifestations of seborrheic keratosis needs further search for new algorithms of therapy and differential diagnosis of malignant skin tumors.