Investigations
Investigations to consider
dermoscopy
Test
The characteristic dermoscopic features of seborrhoeic keratosis are milia-like cysts and comedo-like openings. Milia-like cysts are white or yellowish round structures that correspond to small intra-epidermal, keratin-filled cysts (horn pearls). They are not exclusively found in seborrhoeic keratosis as they are also seen in congenital nevi and papillomatous dermal nevi, but less frequently. Comedo-like openings (also called pseudofollicular openings or crypts) are brownish holes in the surface of seborrhoeic keratosis that correspond histologically to keratin-filled invaginations of the epidermis.[22][23][24]
Result
features of seborrhoeic keratosis
biopsy and histopathological examination
Test
Sharply defined exophytic lesions growing intra-epidermal proliferations composed of mature basaloid cells. The characteristic histological features are keratin-filled invaginations and small cysts (horn cysts). Hyperkeratosis is present in variable degrees.
Result
features of seborrhoeic keratosis
reflectance confocal microscopy (RCM)
Test
RCM is a non-invasive imaging method that allows the in vivo examination of skin at cellular-level resolution. RCM features that indicate the diagnosis of seborrhoeic keratosis are: cerebriform surface structures; keratin-filled invaginations; corneal pseudocysts; a regular honeycomb pattern at epidermal layers; cords and polymorphous papillae at the dermo-epidermal junction; melanophages and looped vessels at the papillary dermis; and the absence of RCM features suggestive of malignancy.[25]
Result
features of seborrhoeic keratosis
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