Thomas Isabelle, Kihiczak Nadia I, Rothenberg Jerry, Ahmed Shahida, Schwartz Robert A
Dermatology, New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103-2714, USA.
Dermatol Surg. 2004 Apr;30(4 Pt 1):559-61. doi: 10.1111/j.1524-4725.2004.30178.x.
Seborrheic keratoses (SKs) are common benign nonmelanocytic epidermal tumors with characteristic clinical features, which are thought to allow a straightforward diagnosis in most situations. As a result, it is an accepted practice to destroy them without histopathologic confirmation. However, systematic reviews of histologic specimens reveal an erroneous clinical diagnosis or associated malignant tumors in a number of cases, including malignant melanomas. We describe a patient with a clinically typical-appearing SK, which was biopsied and histologically proven to be a malignant melanoma arising in the SK. Our report is a reminder that the reliability of clinical diagnosis of SKs needs to be questioned. In addition, a biopsy of SKs is not only warranted but necessary in order to identify a malignant melanoma that would otherwise be misdiagnosed or even completely missed.
脂溢性角化病（SKs）是常见的良性非黑素细胞性表皮肿瘤，具有特征性临床特征，一般认为在大多数情况下可直接诊断。因此，在无组织病理学确诊的情况下对其进行切除是一种公认的做法。然而，对组织学标本的系统回顾显示，在包括恶性黑色素瘤在内的一些病例中存在临床诊断错误或伴有恶性肿瘤。我们报告了一名患者，其临床外观典型的SK经活检组织学证实为起源于SK的恶性黑色素瘤。我们的报告提醒人们，SK临床诊断的可靠性需要受到质疑。此外，对SK进行活检不仅是必要的，而且对于识别可能被误诊甚至完全漏诊的恶性黑色素瘤是必需的。
