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SK Commonly Co-Exists with Lichenoid Keratosis

Clin Exp Dermatol; ePub 2017 Jun 21; Maor, et al

Publish date:

Lichenoid keratosis (LK) is often misdiagnosed as a dermatological malignancy owing to its clinical resemblance to basal cell carcinoma (BCC) or Bowen disease, a recent study found. Researchers performed a retrospective analysis of the pathology records of a series of LK lesions with reference to the demographic features and accuracy of clinical diagnosis. The pathology records from 2008 to 2009 of 263 consecutive patients with a histological diagnosis of LK from a specialized skin laboratory were retrieved. They found:

  • The most common anatomical site was the chest/anterior torso, followed by the back and legs.
  • The most common coexisting lesion was solar keratosis at 14%, followed by seborrheic keratosis (SK) at 7.8%.
  • The correct clinical diagnosis of LK was made in 29.5% of cases.
  • The most common clinical diagnosis was BCC (47%), while SK was the preferred diagnosis in 18%.
  • In conclusion, it appears that LK is frequently misdiagnosed, with misdiagnosis occurring in >70% of cases in this study.

Citation:

Maor D, Ondhia C, Yu LL, Chan JJ. Lichenoid keratosis is frequently misdiagnosed as basal cell carcinoma. [Published online ahead of print June 21, 2017]. Clin Exp Dermatol. doi:10.1111/ced.13178.

Commentary:

Lichenoid keratoses are seen commonly in dermatologic practice and it is not surprising that they are found in association with solar keratoses and seborrheic keratoses. A solitary lesion is present in 90% of cases of lichenoid keratosis, with other patients presenting with few to many lesions. As this article suggests, they are often misdiagnosed as a basal cell carcinoma, but seborrheic keratosis is often in the differential diagnoses as well. Given this fact, a biopsy is often warranted when this entity is considered; dermoscopy may also be useful.
—Jeffrey M. Weinberg, MD, FAAD
Assistant Clinical Professor of Dermatology, Columbia University College of Physicians and Surgeons, NYC
Director, Clinical Research Center/Dermatopharmacology, St. Luke's-Roosevelt Hospital Center, NYC
Acting Director, Division of Dermatology, Jamaica Hospital Medical Center, NYC

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