Llambrich A, Zaballos P, Taberner R, Terrasa F, Bañuls J, Pizarro A, Malvehy J, Puig S
Dermatology, Hospital Son Llatzer, Palma Mallorca, Spain.
Pathology Departments, Hospital Son Llatzer, Palma Mallorca, Spain.
Clin Exp Dermatol. 2016 Jul;41(5):468-73. doi: 10.1111/ced.12832. Epub 2016 Mar 28.
Inverted follicular keratosis (IFK) is an uncommon benign tumour of the follicular infundibulum, which is often misdiagnosed clinically as other keratinizing tumours, and commonly diagnosed correctly by histopathology. There are few reports about the dermoscopic findings of this lesion.
To evaluate the dermoscopic features of IFK.
The dermoscopic structures and patterns in digital dermoscopic images of 12 histopathologically confirmed cases of IFK collected from 5 hospitals in Spain were evaluated.
A keratoacanthoma (KA)-like pattern composed of central keratin surrounded by hairpin vessels in a radial arrangement was the most common pattern in IFK (58.3%). The second most common pattern was composed of a yellowish-white amorphous central area surrounded by vascular structures in a radial arrangement (33.3%). The remaining case showed a pattern composed of a yellowish-white amorphous central area with milky red globules. Vascular structures were present in all cases, with a monomorphic pattern in seven cases and a polymorphic pattern in five, mainly with radial arrangement. Arborizing vessels, linear irregular vessels, corkscrew vessels and milky red globules were present in some cases.
We describe the two main patterns of IFK. Lesions with a KA-like pattern are clinically and dermoscopically undistinguishable from KA and squamous cell carcinoma. Cases with a polymorphic vascular pattern could be confused with malignant tumours, including basal cell carcinoma and amelanotic melanoma.
倒置性毛囊角化病（IFK）是一种罕见的毛囊漏斗部良性肿瘤，临床上常被误诊为其他角化性肿瘤，通常通过组织病理学才能正确诊断。关于该病变的皮肤镜表现的报道较少。
评估IFK的皮肤镜特征。
对从西班牙5家医院收集的12例经组织病理学确诊的IFK数字皮肤镜图像中的皮肤镜结构和模式进行评估。
由中央角质形成，周围有呈放射状排列的发夹样血管组成的角化棘皮瘤（KA）样模式是IFK中最常见的模式（58.3%）。第二常见的模式由淡黄色白色无定形中央区域组成，周围有呈放射状排列的血管结构（33.3%）。其余病例表现为由淡黄色白色无定形中央区域和乳红色小球组成的模式。所有病例均有血管结构，7例为单形性模式，5例为多形性模式，主要呈放射状排列。部分病例可见树枝状血管、线性不规则血管、螺旋状血管和乳红色小球。
我们描述了IFK的两种主要模式。具有KA样模式的病变在临床和皮肤镜下与KA及鳞状细胞癌无法区分。具有多形性血管模式的病例可能与包括基底细胞癌和无色素性黑色素瘤在内的恶性肿瘤相混淆。
