Hamzelou Shahin, Aryanian Zeinab, Maqbool Farah, Kamyab Kambiz, Shakoei Safoura, Azhari Vahidehsadat, Razavi Zahra, Khayyat Azadeh, Ansari Mahshidsadat, Hatami Parvaneh, Smoller Bruce R
Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arch Dermatol Res. 2025 Feb 25;317(1):485. doi: 10.1007/s00403-025-04046-9.
Inverted Follicular Keratosis (IFK) is a uncommon benign tumor, that presents a diagnostic challenge because of its varied clinical and histological appearance. This study aimed to dissect the clinical and pathological features of IFK in patients who have been presented to a tertiary care hospital for five years. Through a cross-sectional analysis, the medical records of 56 patients diagnosed with IFK for four years were meticulously reviewed. The study focused on demographic data, lesion characteristics, pathological findings, and treatment outcomes. The cohort included 56 patients with a mean age of 50.71 ± 19.76 years who were predominantly male (73.2%), with lesions most commonly located on their face (57.1%). The lesions varied in size from 0.3 to 3 cm, with an average size of 1.01 cm. The majority were papular, followed by nodular, plaque, verrucous, and ulcer types, in descending order of frequency. A significant portion of patients (95%) had solitary lesions, predominantly of short duration (less than 3 months). Surgical excision was the primary treatment modality. Pathologically, 50% of lesions exhibited both exo- and endophytic characteristics, with a notable presence of squamous eddies (80%), parakeratosis (79%), and hyperkeratosis (41.1%). Other findings included dyskeratotic cells (62.5%) and a predominance of lymphocytic inflammation when present. A notable association was found between the presence of keratin plugs and lesion location, but no significant correlation was observed between lesion duration and pathological features. This study highlights the clinical and pathological diversity of IFK, with a predominance in males and middle-aged individuals. The findings emphasize the importance of recognizing the variable presentation of IFK to ensure accurate diagnosis and effective management. Surgical excision remains the treatment of choice, reflecting the benign nature of the condition. Further research is warranted to explore the underlying mechanisms and potential for non-surgical treatment options.
