Öz
Aim. Seborrheic keratosis is a benign epidermal tumor, mostly seen in elderly. It has six histopatohological subtypes, including acantotic, hyperkeratotik, irritated, reticular, clonal type
and melanoacantoma. Dermatoscopy (epiluminisence microscopy) is an in vivo, noninvasive technique showing invisible morhological properties of pigmented skin lesions and tumors. The
aim of this study was to determine whether there is a correlation between dermatoscopic findings and histopathological subtypes of seborrheic keratosis.
Method. 80 lesions from 53 patients were included the study. Dermatoscopic findings of the lesions were defined. Incisional biopsy of 77 lesions and excisional bopsy of three lesions were taken and histopathological subtypes were determined.
Results. There was not a significant correlation between histopathological subtypes and some dermatoscopic findins, including comedo-like openings, milia-like cysts, fissures, polimorpheus vessels, dots/globules and blue-white structures (p>0.05). Sausage fingers were more frequent in hyperkeratotic irritated type of seborrheic keratosis (p<0.05). Milia-cloud was more frequent in irritated type, and pseudostreaks and pseudoreticular pattern was more frequent in reticular type of seborrheic keratosis (p<0.05).
Conclusion. Dermatoscopy as a diagnostic tool may be used for the identification of some histopathological subtypes of seborrheic keratosis.
Anahtar Kelimeler
Kaynakça
- Burns T, Breathnach S, Cox N, Griffiths C. Benign epidermal tumors. In: Rook’s Textbook of Dermatology 8th ed. London, Blacwell 2010; 52: 38-9.
- James W, Berger T, Elston D Epidermal nevüsler, neoplaziler, kistler. In: Andrew’s Klinik Dermatoloji 10.baskı. İstanbul 2008, 637-9.
- Silver SG, Ho VCY. Benign epithelial tumors. In: Freedberg IM, Eisen AZ, WollfK, AustenKF, GoldsmithLA, Katz SI, editors. Fitzpatrick'sDermatology in General Medicine, 6th edition, Newyork: McGraw Hill 2003; 767-70.
- Kirkham N. Tumors and cysts of the epidermis. In: Elder D, Elenitsas R, Jaworsky C, Johnson B, editors. Lever‟s Histopatology of the skin. 8th ed. Philadellphiz: Lippincott-Raven Publishers 1997: 685-746.
- Rossiello L, MD, Zalauder I, Ferrare G. Melanoacanthoma simulating pigmented spitz nevus: An usual dermoscopy pitfall. Dermatol Surg 2006; 32: 735-7. Braun R, Rabinovitz H, Oliviero M. Dermoscopic diagnosis of seborrheic keratosis. Clin Dermatol 2002; 20: 270-2.
- Kopf AW, Rabinovitz H, Marghoob A, Braun RP, Wang S, Oliviero M, Polsky D. “Fat fingers”: A clue in the dermoscopic diagnosis in seborrheic keratoses J Am Acad Dermatol 2006; 55: 1089-91.
- Takenouch T. Key points in dermoscopic diagnosis of basal cell carcinoma and seborrheic keratosis in Japanese. J Dermatol 2011; 38: 59-65.
- Burgdorf WHC, Plewig G. Wolff HH. Landthaler M. Benign epithelial tumors. Braun-Falco’s Dermatology third edition, Berlin 2009; 1340-2.
- Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmente skin lesions. J Am Acad Dermatol 2005; 52: 109-21.
- Lin J, Han S, Cui L, Song Z, Gao M, Yang G, Fu Y, Liu X. Evaluation of dermoscopic algorithm for seborrhoeic keratosis: A prospective study in 412 patients. J Eur Acad Dermatol Venereol. 2013.
- Soyer H, Argenziano G, Ruocco V, Dermoscopy of pigmented skin lesions (part II). Eur J Dermatol 2001; 11: 483-98.
- Karaarslan I, Bıyıklı E, Akalın T, Özdemir F. Seboreik keratozların dermoskopik özellikleri; yalancı melanositik lezyon kriterlerinin yeri nedir? Türk Dermatoloji Dergisi 2009; 3: 1-4.
- Scope A, Benvenuto-Andrade C, Agero ALC, Marghoob AA. Nonmelonocytic lesions defying the two-step dermoscopy algorithm. Dermatol Surg 2006; 32: 1398-406.
- Scope A, Agero CA. Nonmelonocytic lesions defying the two-step dermoscopy algorithm. Dermatol Surg 2006; 32: 1398-406.
- Simionescu O, Popescu BO, Costache M, Manole E, Spulber S, Gherghiceanu M, Blum A. Apoptosis in seborrheic keratoses: An open door to a new dermoscopic score. J Cell Mol Med 2012; 16: 1223-31.
Öz
Amaç. Seboreik keratoz daha çok yaşlılarda görülen benign karakterli epidermal bir tümördür. Akantotik, hiperkeratotik, irrite, retiküler, klonal tip ve melanoakantoma olmak üzere 6 farklı histopatolojik alt tipi vardır. Dermatoskopi (epiluminans mikroskopi) pigmente deri lezyonlarının çıplak göz ile görülemeyen klinik morfolojik özelliklerini gösteren in vivo, non-invaziv bir tekniktir. Bu çalışmadaki amacımız seboreik keratozun dermatoskopik özelliklerinin, histopatolojik alt grupları ile korelasyonu olup olmadığını saptamaktı.
Yöntem. Çalışmaya alınan 53 hastanın toplam 80 adet SK lezyonu alındı. Dermatoskopik bulgular tanımlandı. 77 lezyondan insizyonel biyopsi alınırken üç lezyona total rezeksiyon yapıldı ve histopatolojik alt tipler velirlendi.
Bulgular. SK alt tipleri; komedon benzeri açıklıklar, mila benzeri kistler, fissür, polimorf damar, ekzofitik papiller, dot/globül ve mavi beyaz yapı açısından değerlendirildiklerinde istatiksel olarak aralarındaki fark önemsiz bulunmuştur (p>0,05). Alt tiplerde sosis parmak hiperkeratotik tip ve irrite tip SK’da, milia-bulut irrite tip SK en fazla gözlenirken (p<0,05), psödostreaks ve psödoretiküler patern en çok retiküler tip SK’da saptanmıştır (p<0,05).
Sonuç. Dermatoskopi, seboreik keratoz olgularında histopatolojik alt tiplerin belirlenebilmesine yardımcı bir tanı aracı olarak kullanılabilir.
Anahtar Kelimeler
Kaynakça
- Burns T, Breathnach S, Cox N, Griffiths C. Benign epidermal tumors. In: Rook’s Textbook of Dermatology 8th ed. London, Blacwell 2010; 52: 38-9.
- James W, Berger T, Elston D Epidermal nevüsler, neoplaziler, kistler. In: Andrew’s Klinik Dermatoloji 10.baskı. İstanbul 2008, 637-9.
- Silver SG, Ho VCY. Benign epithelial tumors. In: Freedberg IM, Eisen AZ, WollfK, AustenKF, GoldsmithLA, Katz SI, editors. Fitzpatrick'sDermatology in General Medicine, 6th edition, Newyork: McGraw Hill 2003; 767-70.
- Kirkham N. Tumors and cysts of the epidermis. In: Elder D, Elenitsas R, Jaworsky C, Johnson B, editors. Lever‟s Histopatology of the skin. 8th ed. Philadellphiz: Lippincott-Raven Publishers 1997: 685-746.
- Rossiello L, MD, Zalauder I, Ferrare G. Melanoacanthoma simulating pigmented spitz nevus: An usual dermoscopy pitfall. Dermatol Surg 2006; 32: 735-7. Braun R, Rabinovitz H, Oliviero M. Dermoscopic diagnosis of seborrheic keratosis. Clin Dermatol 2002; 20: 270-2.
- Kopf AW, Rabinovitz H, Marghoob A, Braun RP, Wang S, Oliviero M, Polsky D. “Fat fingers”: A clue in the dermoscopic diagnosis in seborrheic keratoses J Am Acad Dermatol 2006; 55: 1089-91.
- Takenouch T. Key points in dermoscopic diagnosis of basal cell carcinoma and seborrheic keratosis in Japanese. J Dermatol 2011; 38: 59-65.
- Burgdorf WHC, Plewig G. Wolff HH. Landthaler M. Benign epithelial tumors. Braun-Falco’s Dermatology third edition, Berlin 2009; 1340-2.
- Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmente skin lesions. J Am Acad Dermatol 2005; 52: 109-21.
- Lin J, Han S, Cui L, Song Z, Gao M, Yang G, Fu Y, Liu X. Evaluation of dermoscopic algorithm for seborrhoeic keratosis: A prospective study in 412 patients. J Eur Acad Dermatol Venereol. 2013.
- Soyer H, Argenziano G, Ruocco V, Dermoscopy of pigmented skin lesions (part II). Eur J Dermatol 2001; 11: 483-98.
- Karaarslan I, Bıyıklı E, Akalın T, Özdemir F. Seboreik keratozların dermoskopik özellikleri; yalancı melanositik lezyon kriterlerinin yeri nedir? Türk Dermatoloji Dergisi 2009; 3: 1-4.
- Scope A, Benvenuto-Andrade C, Agero ALC, Marghoob AA. Nonmelonocytic lesions defying the two-step dermoscopy algorithm. Dermatol Surg 2006; 32: 1398-406.
- Scope A, Agero CA. Nonmelonocytic lesions defying the two-step dermoscopy algorithm. Dermatol Surg 2006; 32: 1398-406.
- Simionescu O, Popescu BO, Costache M, Manole E, Spulber S, Gherghiceanu M, Blum A. Apoptosis in seborrheic keratoses: An open door to a new dermoscopic score. J Cell Mol Med 2012; 16: 1223-31.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 4 Haziran 2014 |
| Yayımlandığı Sayı | Yıl 2014 |