Luo Wen, Liang Yujia, Yang Xianxu, Wu Weiwei, Lu Jiejie
Department of Dermatology, Affiliated Dermatology Hospital of Hainan Medical University, The Fifth People's Hospital of Hainan Province, Haikou, Hainan, People's Republic of China.
Hainan Medical University, Haikou, Hainan, People's Republic of China.
Clin Cosmet Investig Dermatol. 2025 Mar 24;18:721-727. doi: 10.2147/CCID.S517318. eCollection 2025.
Seborrheic keratosis (SK), the most common benign epithelial tumor, frequently presents with cosmetic concerns despite its benign nature. The clinicopathological features of SK may demonstrate notable geographical variability. Diagnosis remains challenging due to varied clinical presentations.
This study aimed to investigate the clinicopathological characteristics of SK through a comprehensive analysis of a large patient cohort.
We conducted a retrospective analysis of clinical and pathological data from 1,169 patients diagnosed with SK between 1 January 2009 and 31 December 2023. Histopathological subtypes were categorized, and a descriptive analysis of demographic and clinical characteristics was performed.
A total of 1,169 SK specimens were identified. The most frequent histopathological subtype was the acanthotic type (79.86%, 960 cases), followed by melanoacanthoma (7.98%, 92 cases), adenoid (5.32%, 64 cases), hyperkeratotic (4.90%, 59 cases), irritated (1.74%, 21 cases), and clonal (0.004%, 6 cases). The male-to-female ratio was 1.3:1, with a higher prevalence in men. SK most commonly affected the head, face, and neck, which accounted for 54.58% of cases (656/1,169), followed by the trunk (28.87%, 347 cases) and extremities (11.48%, 138 cases). The perineal area accounted for 4.48% (54 cases), while mucosal and plantar lesions were rare. The acanthotic subtype predominated across all anatomical sites, including mucosal and plantar regions. The age group most frequently diagnosed with SK was 40-59 years, with the acanthotic, melanoacanthoma, and adenoid types being particularly prevalent in this cohort. The clinical-pathological diagnostic concordance rate was 55.69%, indicating a relatively high rate of diagnostic discrepancy based on visual examination alone.
Our study confirms the acanthotic subtype as the most common histological type of SK, predominantly observed in patients aged 40-59 years. The head, face, and neck emerged as the most frequently involved sites. Ultraviolet radiation may play a significant role in SK pathogenesis.
脂溢性角化病（SK）是最常见的良性上皮性肿瘤，尽管其性质为良性，但常引起美容方面的担忧。SK的临床病理特征可能存在显著的地域差异。由于临床表现多样，诊断仍然具有挑战性。
本研究旨在通过对大量患者队列的综合分析来探讨SK的临床病理特征。
我们对2009年1月1日至2023年12月31日期间诊断为SK的1169例患者的临床和病理数据进行了回顾性分析。对组织病理学亚型进行分类，并对人口统计学和临床特征进行描述性分析。
共鉴定出1169例SK标本。最常见的组织病理学亚型是棘层肥厚型（79.86%，960例），其次是黑素棘皮瘤（7.98%，92例）、腺样型（5.32%，64例）、角化过度型（4.90%，59例）、刺激型（1.74%，21例）和克隆型（0.004%，6例）。男女比例为1.3:1，男性患病率较高。SK最常累及头、面和颈部，占病例的54.58%（656/1169），其次是躯干（28.87%，347例）和四肢（11.48%，138例）。会阴区占4.48%（54例），而黏膜和足底病变罕见。棘层肥厚型在所有解剖部位均占主导地位，包括黏膜和足底区域。最常诊断为SK的年龄组为40 - 59岁，棘层肥厚型、黑素棘皮瘤型和腺样型在该队列中尤为常见。临床病理诊断符合率为55.69%，表明仅基于肉眼检查的诊断差异率相对较高。
我们的研究证实棘层肥厚型是SK最常见的组织学类型，主要见于40 - 59岁的患者。头、面和颈部是最常受累的部位。紫外线辐射可能在SK的发病机制中起重要作用。
