Giant seborrheic keratosis of the face – an unusual presentation
Abstract
Seborrheic keratosis is the most common benign epidermal lesion in the world, especially among the elderly. Its inherent benign nature has precluded the need to remove it for medical reasons. Most of the concerns presented to dermatologists or plastic surgeons are of cosmetic reasons, besides some unusual appearances that necessitate cutaneous malignancy evaluation. Unusually large sizes of seborrheic keratosis are rarely reported, and its clinical significance is largely unknown. It has been proven by recent molecular studies that seborrheic keratosis is true neoplasia rather than a mere epidermal hyperplasia, and various authors have reported several cases of concomitant malignancy arising from seborrheic keratosis. Plastic surgeon expertise is often required when faced with an extensive lesion, requiring reconstructive procedures to preserve good aesthetic and functional outcomes. The purpose of this review is to report a case of an unusually large seborrheic keratosis on the face, highlighting its clinical relevance and surgical management.
References
Hafner C, Vogt T. Seborrheic keratosis. J Dtsch Dermatol Ges 2008; 6(8): 664–677. doi: 10.1111/j.1610-0387.2008. 06788.x.
Jackson JM, Alexis A, Berman B, Berson DS, Taylor S, et al. Current understanding of seborrheic keratosis: Preva-lence, etiology, clinical presentation, diagnosis, and man-agement. J Drugs Dermatol 2015; 14(10): 1119–1125.
Baer RL. Giant pedunculated seborrheic keratosis. Arch Dermatol 1979; 115(5): 627. doi: 10.1001/archderm.1979. 04010050057023.
Beheshti A, Hajmanoochehri F. Seborrheic keratosis with Bowenoid transformation. Comp Clin Path 2015; 24(3):
–704. doi: 10.1007/s00580-014-2042-3.
Boyd AS, Su PF, Shyr Y, Tang YW. Squamous cell carci-nomas in situ arising in seborrheic keratoses: An associa-tion with concomitant immunosuppression? Int J Dermatol 2014; 53(11): 1346–1350. doi: 10.1111/ijd.12086.
Gaffney DC, Muir JB, De'Ambrosis B. Malignant change in seborrhoeic keratoses in a region with high solar ultravi-olet levels. Australas J Dermatol 2014; 55(2): 142–144. doi: 10.1111/ajd.12035.
Terada T. Pigmented Bowen disease arising in pigmented reticulated seborrheic keratosis. Int J Clin Oncol 2010; 15(6): 608–610. doi: 10.1007/s10147-010-0086-1.
Tsai TM, Wu YH, Yang KC, Yang CY, Tsai TH, et al. Sebaceous carcinoma associated with seborrheic keratosis. J Cutan Med Surg 2010; 14(5): 240–244. doi: 10.2310/7750. 2010.09059.
Rajabi P, Adibi N, Nematollahi P, Heidarpour M, Eftekhari M, et al. Bowenoid transformation in seborrheic keratosis: A retrospective analysis of 429 patients. J Res Med Sci 2012; 17(3): 217–221.
Bandyopadhyay D, Saha A, Mishra V. Giant perigenital seborrheic keratosis. Indian Dermatol Online J 2015; 6(1): 39–41. doi: 10.4103/2229-5178.148939.
Longo C, Moscarella E, Piana S, Lallas A, Carrera C, et al. Not all lesions with a verrucous surface are seborrheic ker-atoses. J Am Acad Dermatol 2014; 70(6): e121–e123. doi: 10.1016/j.jaad.2013.10.042.
Thomas I, Kihiczak NI, Rothenberg J, Ahmed S, Schwartz RA. Melanoma within the seborrheic keratosis. Dermatol Surg 2004; 30(4): 559–561. doi: 10.1111/j.1524-4725.2004. 30178.x.
Birnie AJ, Varma S. A dermatoscopically diagnosed colli-sion tumour: Malignant melanoma arising within a sebor-rhoeic keratosis. Clin Exp Dermatol 2008; 33(4): 512–513. doi: 10.1111/j.1365-2230.2008.02715.x.
Salerni G, Alonso C, Gorosito M, Fernández-Bussy R. Se¬borrheic keratosis-like melanoma. J Am Acad Dermatol 2015; 72(1 Supp1): S53–S55. doi: 10.1016/j.jaad.2014. 07. 009.
Lim C. Seborrhoeic keratoses with associated lesions: A re¬tro¬spective analysis of 85 lesions. Australas J Dermatol 2006; 47(2): 109–113. doi: 10.1111/j.1440-0960.2006.00258.x.
Vun Y, De'Ambrosis B, Spelman L, Muir JB, Yong‐Gee S, et al. Seborrhoeic keratosis and malignancy: Collision tumour or malignant transformation? Australas J Dermatol 2006; 47(2): 106–108. doi: 10.1111/j.1440-0960.2006.00242. x.
Noiles K, Vender R. Are all seborrheic keratoses benign? Review of the typical lesion and its variants. J Cutan Med Surg 2008; 12(5): 203–210. doi: 10.2310/7750.2008. 07096.
Ponti G, Luppi G, Losi L, Giannetti A, Seidenari S. Le-ser-Trélat syndrome in patients affected by six multiple metachronous primitive cancers. J Hematol Oncol 2010; 3: 2. doi: 10.1186/1756-8722-3-2.
Baker SR. Local flaps in facial reconstruction: Expert con-sult. 3rd ed. Philadelphia: Elsevier Health Sciences; 2014.
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