AbstractBackground: Seborrheic keratosis (SK) is among the most frequently encountered benign epithelial tumors and is typically diagnosed based on clinical features. However, its resemblance to other pigmented or verrucous lesions, including malignant neoplasms, can lead to diagnostic uncertainty, highlighting the need for histological verification in selected instances. This study aimed to assess the consistency between clinical impressions and histopathological outcomes in cases of SK.
Materials and Methods: A retrospective descriptive study was carried out in the Department of Pathology at Tagore Medical College, Chennai, covering the period from January to December 2015. All biopsy samples that were clinically labeled as SK were analyzed. Sections stained with hematoxylin and eosin were examined microscopically. A comparative analysis was performed between the initial clinical diagnosis and the final histological findings. Diagnostic metrics such as sensitivity, specificity, and overall accuracy were calculated.
Results: Among 110 cases clinically suspected to be SK, histological confirmation was obtained in 92 cases (83.6%). In 18 cases (16.4%), alternate diagnoses were established, including basal cell carcinoma (4 cases), verruca vulgaris (5), actinic keratosis (3), and benign appendageal tumors (6). Clinical assessment of SK demonstrated a sensitivity of 92%, specificity of 78%, and overall diagnostic accuracy of 85.4%. The predominant histopathological subtypes identified were acanthotic (45.6%), hyperkeratotic (28.3%), and adenoid (14.1%).
Conclusion: While clinical diagnosis of seborrheic keratosis is often dependable, histopathological confirmation is crucial in atypical or doubtful presentations to rule out malignancy. The findings affirm the value of integrating clinical judgment with microscopic evaluation in dermatological diagnostics.
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