Dermoscopy Of Plane-wart-like Seborrheic Keratosis

Background and objectSeborrheic keratosis is a benign, exceedingly common epithelial skin neoplasm, caused of the slow maturity of the Keratinocyte. And most individuals will develop one or even many of them during their lifetime, especially the old person. Atypical SK especially the plane-wart-like SK may be confused with plane warts, especially when plane warts are developed or are still persistent in a relatively elder person, or when plane-wart-like seborrheic keratoses emerge in a younger individual. However, the treatment approaches for the two conditions are not completely same. And plane warts may regress spontaneously in a few weeks or months, or they may persistent for years remaining the flat appearance; whereas the lesions in seborrheic keratoses in general tend to increase in both number and size with age and will eventually become verrucous, polypoid or pedunculated. In addition, seborrheic keratoses may be associated with malignancy.Dermoscopy as a noninvasive and simple and convenient inspection tool is widely applied to the diagnosis and differential diagnosis of pigmented skin disease and some inflation disease, such as erythema exudativum multiforme, lichen planus, pasoriasis, purpura, pityriasis rosea, Bowenoid papulosis et al. Vivo this we can directly observer micro-structure of the skin lesion,and it has opend a new area for skin morphological studing. Dermoscopy also has obvious advantages in reducing unnecessary biopsies, having a convenient follow-up for patients, preservating and picking up imag data.There are quit pare of researches about the clinical application of dermoscopy in SK at home and abroad. The dermascopic manifestations of SK including comedo-like openings, milialike cysts, hairpin vessels, brainlike appearance, mouth eaten border, sharply demarcated and so on. Thereinto comedo-like openings and milialike cysts are the main manifestations. But there are no special reports including the dermoscopic manifestations of plane-warts-like SK. Therefore the aim of this study is to observe and analyse the dermascopic manifestation of plane-wart-like SK. So settle a foundation for the differential diagnosis of plane warts and plane-wart-like SK.Methods1. We collected consecutively 105 cases of SK lesions in the dermatology department physical examination department of the First Affiliated Hospital of Zhengzhou University from March,2010 to Dec,2010. All the cases we chose are made a definite diagnosis of SK, and that we have any question about the SK diagnosis would be removed. After we collected the patients'medicine history information and the clinical and dermoscopy images of the lesions, a famous doctor who is good at dermoscopy would have a detailed analysis of all the images and make out the dennosopy criterias and features.2. Main outcome measures and statistics:We calculated the information about the 105 cases of SK including the location of every lesion, color, shape, and the preference of every criteria of dermoscopy in SK.Results1.49 patients and 105 cases of plane-wart-like SK were selected as eligible for this study. There were 28(57.14%) cases for male,21(42.86%) cases for female with the ratio1.33:1. The maximum age was 85 years old and the minimum was 29 years with the average age for the patients when they see a doctor was 63.94±1.89 years old, All of the 105 cases, single lesion were 12(11.43%) and multiple were 93(88.57%). 2. Global features of plane-wart-like SK:We find that there are 27(25.71%) homogeneous pattern.34(32.38%) cases are blotch pattern, among of them there are 20(58.82%) cases accompanying keratosis, including dotting and reticular even membranaceous keratosis.27(25.71%) cases are dotting feature without prominent keratosis.12(11.43%) cases are fissure pattern,4(3.81%) cases are field shape pattern, and 1(0.95%) special case is lace shape pattern.3. local features of plane-wart-like SK:we find some local features in 40(38.10%) cases, including dotting vessel, comedo-like opening, moth eaten border, stared pattern, reticular pattern, keratinized hair follicle, fingerprinting pattern, bluewhite veil.Conclusion1. The prominent global featuers of plane-wart-like SK are homogeneous pattern, blotch pattern, dotting feature, fissure pattern, field shape pattern and lace shape pattern2. The prominent local featuers of plane-wart-like SK including dotting vessel, fingerprinting pattern, stared pattern and comedo-like opening..