First Department of Dermatology, Aristotle University, Thessaloniki, Greece.
First Department of Dermatology, Aristotle University, Thessaloniki, Greece.
J Am Acad Dermatol. 2021 Nov;85(5):1143-1150. doi: 10.1016/j.jaad.2020.02.019. Epub 2020 Feb 14.
Even with the addition of dermoscopy, a significant morphologic overlap exists between irritated seborrheic keratosis (ISK) and squamous cell carcinoma (SCC).
The aim of this study was to investigate the dermoscopic criteria that could serve as potent predictors for the differential diagnosis between ISK and SCC.
Dermoscopic images of histopathologically diagnosed ISKs and SCCs were evaluated by 3 independent investigators for the presence of predefined criteria.
A total of 104 SCCs and 61 ISKs were included. The main dermoscopic predictors of SCC were dotted vessels (odds ratio [OR], 10.4), branched linear vessels (OR, 5.30), white structureless areas (OR, 6.78), white circles surrounding follicles (OR, 23.45), a diffuse irregular (OR, 2.55) or peripheral (OR, 2.8) vessel arrangement, and a central scale arrangement (OR, 3.35). Dermoscopic predictors of ISK were hairpin vessels (OR, 0.38), a diffuse regular vessel arrangement (OR, 0.39 and OR, 0.36), and white halos surrounding vessels covering more than 10% of the lesion (OR, 0.29 and OR, 0.12).
First, the retrospective design of the study; second, the differential diagnosis included in the study was restricted to ISK and SCC.
We confirmed the significant morphologic overlap between ISK and SCC, but we also identified potent predictors for the differential diagnosis between these 2 entities.
即使加入了皮肤镜检查，刺激性脂溢性角化病（ISK）和鳞状细胞癌（SCC）之间仍存在显著的形态学重叠。
本研究旨在探讨可作为 ISK 和 SCC 鉴别诊断有力预测指标的皮肤镜标准。
由 3 名独立研究者评估经组织病理学诊断为 ISK 和 SCC 的皮肤镜图像，以评估是否存在预先定义的标准。
共纳入 104 例 SCC 和 61 例 ISK。SCC 的主要皮肤镜预测指标包括点状血管（优势比[OR]，10.4）、分支线性血管（OR，5.30）、白色无结构区域（OR，6.78）、围绕毛囊的白色无结构区域（OR，23.45）、弥漫性不规则（OR，2.55）或周边（OR，2.8）血管排列以及中央鳞屑排列（OR，3.35）。ISK 的皮肤镜预测指标包括发夹状血管（OR，0.38）、弥漫性规则血管排列（OR，0.39 和 OR，0.36）以及覆盖病变 10%以上的血管周围的白色晕环（OR，0.29 和 OR，0.12）。
首先，研究的回顾性设计；其次，研究中纳入的鉴别诊断仅限于 ISK 和 SCC。
我们证实了 ISK 和 SCC 之间存在显著的形态学重叠，但我们也确定了这两种实体之间鉴别诊断的有力预测指标。
