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

Adult ; Diagnosis, Differential ; Female ; Humans ; Nevus, Sebaceous of Jadassohn ; diagnosis ; pathology ; Psoriasis ; diagnosis ; pathology

Linear lichen planus (LLP) is a rare variant of lichen planus, which accounts for 0.24-0.62% of all patients with lichen planus. Blaschko lines are the pattern assumed by many different nevoid and acquired skin diseases on the human skin, which present with a characteristic S-shape on the abdomen, a V-shape near the posterior midline, a linear pattern on the lower trunk and limbs, and whorls on the scalp and abdomen. Multiple LLP along the lines of Blaschko has been rarely reported. Differential diagnosis of LLP includes lichen striatus, epidermal nevi, linear psoriasis, inflammatory linear verrucous epidermal nevus (ILVEN), linear Darier disease, linear lupus erythematosus, and linear lichen nitidus. We herein describe a 49-year-old female who showed multiple linear erythematous, brownish papules on her right trunk, shoulder, arm, and groin with typical histopathologic findings of lichen planus.
Abdomen ; Arm ; Darier Disease ; Diagnosis, Differential ; Extremities ; Female ; Groin ; Humans ; Lichen Nitidus ; Lichen Planus* ; Lichens* ; Middle Aged ; Nevus ; Nevus, Sebaceous of Jadassohn ; Psoriasis ; Scalp ; Shoulder ; Skin ; Skin Diseases

A clinical and histological study of typical sebaceous epithelioma (basal cell epitheioma with sebaceous differentiation) developed secondarily in lesions of nevus sebaceus of Jadassohn is presented. The patient was 42 years old male. The sebaceous epithelioma tends to have about the same clinical characteristics as undifferentiated basal cell epithelioma but it is more often a yellow color. Sebaceous epitheliova may arise from nevus sebaceus and it is preursor of undifferentiated basal ce]1 epithelioma. Histological]y, the preparation showed massive development of sebaceous gland, papillomatous epidermal hyperplasia and maturation of apocrine glands. The tumor cell nests were mostly composed of large sheets of irregularly shaped cells in palisading pattern at the periphery. There were Iarge number of cells with vacuolated cytoplasm resembling sebaceous cell in certain part of the tumor cell masses and several keratin pearls. Diagnosis confirmed by clinical appearance and histological picture. These lesions could be treated sucessfully by wide excision.
Adult ; Apocrine Glands ; Carcinoma* ; Carcinoma, Basal Cell ; Cytoplasm ; Diagnosis ; Humans ; Hyperplasia ; Male ; Nevus* ; Nevus, Sebaceous of Jadassohn* ; Sebaceous Glands