A new study published in the Journal of the College of Physicians and Surgeons Pakistan aimed to describe the features of facial seborrheic keratosis, verruca plana and nevus pigmentosus by dermatoscopy and reflective confocal microscope (RCM).

This cross-sectional observational study was conducted in the Dermatology Department of The Affiliated Hospital of Xuzhou Medical University, between 2017 and 2019.Patients clinically diagnosed with seborrheic keratosis, verruca plana and nevus pigmentosus—without any prior treatment—were enrolled. One typical skin lesion was chosen from each patient and subjected to dermatoscopy and RCM separately – imaging features were recorded and analyzed.

Overall, 402 patients – 183 men and 219 women, between 6 and 88 years of age were recruited. The duration of the disease was between one week and 10 years. It was observed that seborrheic keratosis on dermatoscopy presented as acne-like openings in 70.93%;milia-like cysts in 65.70%; hairpin-like vessels in62.79%; brain-like structures in 59.88%; worm-like pharyngeal margins in 9.88%; and fingerprint-like structures in 4.65%. Meanwhile, on RCM, epidermal cerebral gyrus structure was seen in 95.93% cases; superficial vasodilatation and hyperemia in 47.09%; and keratinous cysts in 42.44%. While verruca plana, on RCM, showed rose-like concentric structures in 78.07%; nevus pigmentosuselicited only a few nevus cells within the dermal papilla—for intradermal nevus; elliptical nevus cells in the basal layer—for junctional nevus; and nevus cells in the epidermis and dermis—for compound nevus.

It was concluded that when used in combination, the application of dermatoscopy and RCM may help in distinguishing seborrheic keratosis, verruca plana and nevus pigmentosus, when coupled with clinical findings. 

Source: Journal of the College of Physicians and Surgeons Pakistan. 2021 Apr;30(4):450-454.doi:10.29271/jcpsp.2021.04.450.