OBJECTIVES: Verrucous epidermal nevus (VEN), seborrheic keratosis (SK), verruca plana (VP), verruca vulgaris (VV), and nevus sebaceous (NS) are common verrucous proliferative skin diseases with similar clinical appearances, often posing diagnostic challenges. Dermoscopy and reflectance confocal microscopy (RCM) can aid in their differentiation, yet their specific features under these tools have not been systematically described. This study aims to summarize and analyze the dermoscopic and RCM features of VEN, SK, VP, VV, and NS. METHODS: A total of 121 patients with histopathologically confirmed verrucous proliferative skin diseases were enrolled. Dermoscopy and RCM imaging was used to observe and analyze the microscopic features of these conditions. RESULTS: Under dermoscopy, the 5 diseases displayed distinct characteristics: VEN typically showed gyriform structures; SK was characterized by gyriform structures, comedo-like openings, and milia-like cysts; VP and VV featured dotted vessels and frogspawn-like structures; NS presented as brownish-yellow globules. RCM revealed shared features such as hyperkeratosis and acanthosis across all 5 diseases. Specific features included gyriform structures and elongated rete ridges in VEN; pseudocysts and gyriform structures in SK; evenly distributed ring-like structures in VP; vacuolated cells and papillomatous proliferation in VV; and frogspawn-like structures in NS. CONCLUSIONS These 5 verrucous proliferative skin conditions exhibit distinguishable features under both dermoscopy and RCM. The combination of these 2 noninvasive imaging modalities holds significant clinical value for the differential diagnosis of verrucous proliferative skin diseases.
Humans ; Dermoscopy/methods* ; Diagnosis, Differential ; Microscopy, Confocal/methods* ; Male ; Female ; Adult ; Middle Aged ; Adolescent ; Keratosis, Seborrheic/pathology* ; Young Adult ; Warts/diagnosis* ; Child ; Aged ; Skin Diseases/pathology* ; Nevus, Sebaceous of Jadassohn/diagnosis* ; Skin Neoplasms/diagnosis* ; Child, Preschool

PURPOSE: To report the relative frequency and clinical characteristics of patients with benign eyelid tumors. METHODS: A retrospective study of 192 consecutive patients admitted to Korea University Ansan Hospital with benign eyelid tumor between January 2009 and December 2014 was undertaken, and clinical records including age, sex, involved site, and pathology of tumors were reviewed retrospectively. All eyelid tumors were confirmed histopathologically. RESULTS: The sexual distribution revealed 87 males and 105 females with benign eyelid tumors. The mean age at diagnosis was 42.6 +/- 19.2 years. Molluscum contagiosum (5.5 +/- 3.5 years) and pilomatrixoma (14.0 +/- 15.6 years) were generally found in younger individuals, while seborrheic keratosis (60.2 +/- 15.8 years) and squamous cell papilloma (50.5 +/- 13.4 years) occurred predominantly in elderly patients. Tumors were most common on the upper lid (63.0%). The four most frequent subtypes were melanocytic nevus (37.5%), epidermal cyst (8.3%), squamous cell papilloma (5.7%), and seborrheic keratosis (5.2%). CONCLUSIONS: The most common histopathological diagnosis of benign eyelid tumors was melanocytic nevus. The results of this study provide epidemiological information that will be useful for diagnosis and therapy of such tumors.
Aged ; Diagnosis ; Epidermal Cyst ; Eyelids* ; Female ; Gyeonggi-do ; Humans ; Keratosis, Seborrheic ; Korea ; Male ; Molluscum Contagiosum ; Nevus, Pigmented ; Papilloma ; Pathology ; Pilomatrixoma ; Retrospective Studies

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.
Adenoids ; Biopsy ; Classification ; Humans ; Keratosis, Seborrheic* ; Pathology ; Skin

BACKGROUND: There have been many changes to the social and medical environment in Korea and many studies showed a steady increase of cutaneous tumors. But none of them included a data occurring from head and neck. OBJECTIVE: To investigate the incidence and distribution of the cutaneous tumors of the head and neck. METHODS: A total of 1,415 cases of head and neck cutaneous tumors were obtained from pathology specimen at Department of Dermatology between 2010 and 2014. RESULTS: Among 1,415 cases of head and neck cutaneous tumors, 871 cases (61.5%) were benign tumors, 271 cases (19.2%) were malignant tumors, and 273 cases (19.2%) were premalignant lesions. The most common benign head and neck cutaneous tumors was epidermal cyst with 188 cases (21.6%), followed by 173 cases (19.9%) of seborrheic keratosis, 71 cases (8.2%) of intradermal nevi. Among the 271 cases of malignant head and neck cutaneous tumors, there were 164 cases (60.5%) of basal cell carcinoma, 89 cases (32.8%) of squamous cell carcinoma, 5 cases (1.8%) of malignant melanoma. The predilection sites of malignant head and neck tumors were face (87.5%), ear (4.8%) and neck (4.0%). Of the premalignant lesions, there were 210 cases (76.9%) of actinic keratosis, 36 cases (13.2%) of Bowen's disease and 27 cases (9.9%) of actinic cheilitis. CONCLUSION: In our study, the proportion of malignant tumors and premalignant lesion in head and neck tumors was higher than previous reports. Also, the percentage of woman in malignant tumors and premalignant lesions was higher than man, unlike previous studies. However, these results had limitation associated with retrospective study in a single institution, and further prospective study with multi-center is required for confirmation.
Actins ; Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Clinical Study* ; Dermatology ; Ear ; Epidermal Cyst ; Female ; Head* ; Humans ; Incidence ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Melanoma ; Neck* ; Nevus, Intradermal ; Pathology ; Prospective Studies ; Retrospective Studies

BACKGROUND: Merkel cell carcinoma (MCC) is an increasingly common neuroendocrine cancer of the skin. Merkel cell polyomavirus (MCPyV) is one of the causative agents of MCC. The prevalence of MCPyV in primary MCC and sun-exposed non-MCC tumors has been known to have different results depending on where it was investigated. OBJECTIVE: This study assesses the prevalence of MCPyV from primary MCC and sun-exposed non-MCC tumors in Korea. METHODS: A molecular pathology study was performed on 7 tissue specimens of MCC, 1 tissue specimen of metastatic small cell carcinoma of the lung, and 32 tissue specimens of non-MCC tumors occurring from sun-exposed areas [8 basal cell carcinomas (BCCs), 8 squamous cell carcinomas (SCCs), 8 actinic keratoses (AKs), and 8 seborrheic keratoses (SKs)]. All specimens were analyzed to determine the presence of MCPyV-DNA using both polymerase chain reaction (PCR) and real-time quantitative PCR. Immunohistochemistry with monoclonal antibody of MCPyV large T antigen (CM2B4) was also conducted. RESULTS: Using both PCR, MCPyV sequences were detected in six of seven MCC tissue specimens (85.7%). Five (71%) of seven MCC tumors were immunoreactive for CM2B4. All five immunoreactive cases were positive for MCPyV. However, there was no association of MCPyV with BCC, SCC, AK, and SK. CONCLUSION: Our results implicate that MCPyV may contribute to the pathogenesis of primary MCC, not of non-MCC skin tumors in Korea, and the persons with MCPyV infection are unusual in Korea compared to other areas.
Antigens, Viral, Tumor ; Carcinoma, Basal Cell ; Carcinoma, Merkel Cell ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Humans ; Immunohistochemistry ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Lung ; Merkel cell polyomavirus ; Pathology, Molecular ; Polymerase Chain Reaction ; Prevalence ; Skin ; Skin Neoplasms

When two or more cutaneous tumours coexist in a single lesion, it is known as a cutaneous collision or contiguous tumour. Various combinations of collisions have been described. Collision tumours often have misleading clinical and histological presentations, and can be a diagnostic challenge. Chondroid syringomas are mixed cutaneous tumours of dual origin, and like collision tumours, are often confused with the more commonly seen cutaneous lesions. As chondroid syringomas are rare, their involvement in collision tumours is an even more peculiar occurrence. We report an unusual case of a cutaneous collision tumour on the nose involving an intradermal naevus and chondroid syringoma. To the best of our knowledge, this is the first time such a combination is reported.
Aged ; Carcinoma, Basal Cell ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Keratosis, Seborrheic ; pathology ; Neoplasms, Multiple Primary ; pathology ; Nevus, Pigmented ; pathology ; Nose Neoplasms ; diagnosis ; Skin Neoplasms ; pathology

OBJECTIVETo detect the expression of stem cell transcription factor Oct-4 in squamous cell carcinoma (SCC) and seborrheic keratosis (SK) and its association with cancer stem cells.

METHODSImmunohistochemistry was used to detect Oct-4 expression in 35 SCC cases, 21 SK cases and 15 normal control skin tissues.

RESULTSOct-4 expression was negative in normal skin and showed a significant difference between SCC and SK tissues (P<0.05).

CONCLUSIONThe Oct-4-positive cells in SCC and SK are probably tumor stem cells. Oct-4 expression may provide an important evidence for isolation and identification of human SCC and SK stem cells.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Case-Control Studies ; Female ; Humans ; Keratosis, Seborrheic ; metabolism ; pathology ; Male ; Middle Aged ; Octamer Transcription Factor-3 ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; Young Adult

An 83-year-old woman had undergone an external dacryocystorhinostomy with silicone intubation. Before the surgery, no skin lesions were observed on the incision site. Three months after surgery, the patient complained of a brown-to-black pigmented elevation at her previous skin incision site. A punch biopsy of the pigmented mass was performed. The histopathologic findings confirmed the clinical diagnosis of irritated seborrheic keratosis (SK). SK can occur several months postoperatively and can suddenly increase in size, so surgeons need to carefully check patients' skin prior to surgery. To our knowledge, this is the first reported case of irritated SK discovered on a previous skin incision site.
Aged, 80 and over ; Dacryocystorhinostomy/*adverse effects ; Female ; Follow-Up Studies ; Humans ; Keratosis, Seborrheic/*etiology/pathology/surgery ; Laser Therapy ; Lasers, Gas

BACKGROUND: There have been many changes to the social and medical environment in Korea over the last 30 years. Therefore, we presume that distribution and incidence of skin tumors might have changed. This is the first report to analyse skin tumors in the Jeonbuk province over the past 27 years (1978~2004). OBJECTIVE: To investigate the incidence and distribution of skin tumors among people of the Jeonbuk province. METHODS: A total of 4,037 cases of skin tumor were obtained from surgical pathology specimen at Department of Dermatology in Chonbuk National University Hospital. RESULTS: Among the 4,037 cases of skin tumors, 2,856 cases (70.8%) were benign tumors, 841 cases (20.8%) were malignant tumors, and 340 cases (8.4%) were premalignant lesions. The most common benign skin tumor was melanocytic nevi with 402 cases, followed by 299 cases of seborrheic keratosis, 298 cases of epidermal cyst, and 136 cases of nevus sebaceus. Among the 841 cases of malignant skin tumors, there were 309 cases of basal cell carcinoma, 192 cases of squamous cell carcinoma, 66 cases of malignant melanoma, and 55 cases of malignant lymphoma. Of the premalignant lesions, there were 271 cases of actinic keratosis, 67 cases of Bowen's disease and 2 cases of lentigo maligna. The predilection sites of melanocytic nevi were the face (50.0%), trunk (13.9%), scalp (11.0%), foot (9.5%), and those of seborrheic keratosis were the face (37.5%), followed by the scalp (23.1%). The predilection site of basal cell carcinoma, squamous cell carcinoma and actinic keratosis was the face (86.9%, 57.8%, 82.3%). Over the past 10 years (1994~2004), benign tumors, malignant tumors and premalignant lesions have occurred with a ratio of 58.4%, 68.7%, and 77.2% respectively. 220 patients with malignant tumors were transferred for treatment or evaluation to other departments or hospitals. Form these, the most common type of tumor was basal cell carcinoma (56 cases), followed by squamous cell carcinoma (44 cases). CONCLUSION: We reviewed 4,037 cases of skin tumor, confirmed histopathologically within at the Department of Dermatology at the Chonbuk National University Hospital between 1978 and 2004. This data will be made available for the study of skin tumors in Korea.
Bowen's Disease ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Epidermal Cyst ; Foot ; Humans ; Hutchinson's Melanotic Freckle ; Incidence ; Jeollabuk-do* ; Keratosis, Actinic ; Keratosis, Seborrheic ; Korea ; Lymphoma ; Melanoma ; Nevus ; Nevus, Pigmented ; Pathology, Surgical ; Scalp ; Skin*

OBJECTIVETo investigate the effect of stat3 phosphorylation and p53 expression on human epidermal non-melanoma cutaneous tumours.

METHODSImmunohistochemistry technique was employed to measure the expression of p-stat3 and p53 protein in skin tissue from 30 cases of skin squamous cell carcinoma (SCC), 20 cases of basal cell carcinoma (BCC), 20 cases of seborrhoeic keratosis (SK) and 20 normal subjects.

RESULT(1) p-stat3 protein was abnormally increased in SCC and BCC as compared with normal skin and SK. Expression of p-stat3 in SCC was also significantly higher than that in BCC. (2) Expression of p-stat3 was higher in poorly-differentiated cancers than that in well-differentiated cancers in SCC. The positive rate of p-stat3 expression was correlated with the depth of tumor invasion, but not with tumor size. (3) There was no p53 protein expression on normal skin and SK, it was significantly upregulated in SCC and BCC. In SCC, the intensity of p53 expression was associated with tumor differentiation. There was no correlation between the positive rate of p53 expression and the depth of tumor invasion, whereas the positive rate of p53 expression was correlated with the sun-exposure area. (4) There existed positive correlation between the expression intensity of p-stat3 and p53 in SCC (r=0.641, P<0.05).

CONCLUSION(1) The overexpression of p-stat3 may play an important role in the development of epidermal tumors. (2) The abnormal activation of stat3 may be related to metastatic potentials in SCC. (3) Both p53 gene and stat3 may contribute to the pathogenesis of skin SCC.

Carcinoma, Basal Cell ; chemistry ; pathology ; Carcinoma, Squamous Cell ; chemistry ; pathology ; DNA-Binding Proteins ; metabolism ; Humans ; Immunohistochemistry ; Keratosis, Seborrheic ; metabolism ; Phosphorylation ; STAT3 Transcription Factor ; Skin ; chemistry ; Skin Neoplasms ; chemistry ; pathology ; Trans-Activators ; metabolism ; Tumor Suppressor Protein p53 ; analysis