Venturi Federico, Cedirian Stephano, Veronesi Giulia, Scotti Biagio, Baraldi Carlotta, Dika Emi
Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Skin Res Technol. 2025 Jul;31(7):e70206. doi: 10.1111/srt.70206.
Studies have found that few lesions clinically diagnosed as seborrheic keratosis (SK) revealed Cutaneous melanoma (CM) on histopathology. When CM mimics SK, they are defined as seborrheic keratosis-like melanoma (SKLM), and a delayed diagnosis and treatment can occur.
We conducted a retrospective descriptive, monocentric study of the epidemiological, clinical, videodermoscopy (VDS), and reflectance confocal microscopy (RCM) characteristics of histopathologically proven SKLM diagnosed between 2018 and 2024.
The study population consisted of 60 patients: 44 males (73.3%) and 16 females (26.7%) with lesions located in 73.3% of cases on the trunk. Concerning histological type, superficial spreading melanoma was the more frequent (86.7%). More than 50% of tumors had a Breslow thickness <0.8 mm. The findings from the VDS examination using the revised Argenziano Seven Point Checklist revealed that 100% of cases presented at least one dermoscopic melanoma-specific criterion and, for this reason, had an indication for surgical excision. Typical RCM patterns associated with melanoma diagnosis were observed, including irregular honeycomb/cobblestone pattern (82.1%), irregular DEJ nests (78.6%), dermal inflammation (53.6%), irregular dermal nests (53.6%), dendritic cells in sheets/tangled lines (50%), and atypical round cells (39.3%).
Our study provides valuable insights into the dermoscopic, RCM, and histological features of SKLM based on the largest monocentric cohort. The distinctive dermoscopic patterns, along with the confocal features, aid in the differentiation from other pigmented lesions.
研究发现，临床诊断为脂溢性角化病（SK）的病变在组织病理学上很少显示为皮肤黑色素瘤（CM）。当CM模仿SK时，它们被定义为脂溢性角化病样黑色素瘤（SKLM），可能会出现诊断和治疗延迟的情况。
我们对2018年至2024年间经组织病理学证实的SKLM的流行病学、临床、视频皮肤镜检查（VDS）和反射式共聚焦显微镜检查（RCM）特征进行了一项回顾性描述性单中心研究。
研究人群包括60例患者：44例男性（73.3%）和16例女性（26.7%），73.3%的病例病变位于躯干。关于组织学类型，浅表扩散性黑色素瘤最为常见（86.7%）。超过50%的肿瘤Breslow厚度<0.8mm。使用修订后的阿金齐亚诺七点检查表进行的VDS检查结果显示，100%的病例至少呈现一项皮肤镜黑色素瘤特异性标准，因此有手术切除指征。观察到与黑色素瘤诊断相关的典型RCM模式，包括不规则蜂窝/鹅卵石模式（82.1%）、不规则表皮真皮交界处巢状结构（78.6%）、真皮炎症（53.6%）、不规则真皮巢状结构（53.6%）、片状/缠结状树突状细胞（50%）和非典型圆形细胞（39.3%）。
我们的研究基于最大的单中心队列，为SKLM的皮肤镜、RCM和组织学特征提供了有价值的见解。独特的皮肤镜模式以及共聚焦特征有助于与其他色素性病变相鉴别。
