The role of immunosuppression in squamous cell carcinomas arising in seborrheic keratosis.
J Am Acad Dermatol 2017;
76:1146-1150. [PMID:
28162852 DOI:
10.1016/j.jaad.2016.12.002]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND
Seborrheic keratoses (SK) are common skin neoplasms considered to be benign. Reports of associated squamous cell carcinoma arising within seborrheic keratosis (SCC-SK) have been described.
OBJECTIVE
To describe the histopathologic characteristics of SCC-SK and identify predisposing factors in formation of these rare lesions.
METHODS
There were 162 cases of SCC-SK in a span of a decade (2003-2014). All of the histopathologic specimens and medical records were reviewed. Data from these patients were compared to a control group with seborrheic keratosis who were matched by age, sex, and location of lesion from the same time period (n = 162).
RESULTS
SCC-SK has the classic histopathologic features of SK, such as hyperkeratosis, parakeratosis, papillomatosis, and pseudohorn cysts. The areas of squamous cell carcinoma were characterized by areas of squamous dysplasia (100%), hypogranulosis (79.6%), squamous eddies (79.6%), solar elastosis (80.9%), and brown pigmentation (59.9%). Patients with a history of immunosuppression had an increased risk for developing SCC-SK (19% vs 3%; P < .01), particularly when inhibition was transplant-associated (10% vs 0%; P < .01).
LIMITATIONS
This was a single center, retrospective study.
CONCLUSION
SCC-SK occurs more often in elderly men with a history of immunosuppression associated with organ transplants.
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